AB150,1061,25 2049.35 Public assistance; supervisory functions of department. (1) (a)
21The department shall supervise the administration of programs under this
22subchapter. The department shall submit to the federal authorities state plans for
23the administration of programs under this subchapter in such form and containing
24such information as the federal authorities require, and shall comply with all
25requirements prescribed to ensure their correctness.
AB150,1062,8
1(b) All records of the department and all county records relating to programs
2under this subchapter and aid under s. 49.18, 1971 stats., s. 49.20, 1971 stats., and
3s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973, shall be open to
4inspection at all reasonable hours by authorized representatives of the federal
5government. Notwithstanding s. 48.396 (2), all county records relating to the
6administration of the services and public assistance specified in this paragraph shall
7be open to inspection at all reasonable hours by authorized representatives of the
8department.
AB150,1062,199 (bm) All records of the department relating to aid provided under s. 49.19 are
10open to inspection at reasonable hours by members of the legislature who require the
11information contained in the records in pursuit of a specific state legislative purpose.
12All records of any county relating to aid provided under s. 49.19 are open to inspection
13at reasonable hours by members of the board of supervisors of the county or the
14governing body of a city, village or town located in the county who require the
15information contained in the records in pursuit of a specific county or municipal
16legislative purpose. The right to records access provided by this paragraph does not
17apply if access is prohibited by federal law or regulation or if this state is required
18to prohibit such access as a condition precedent to participation in a federal program
19in which this state participates.
AB150,1063,320 (c) The department may at any time audit all county records relating to the
21administration of the services and public assistance specified in this section and may
22at any time conduct administrative reviews of county departments under ss. 46.215,
2346.22 and 46.23. If the department conducts such an audit or administrative review
24in a county, the department shall furnish a copy of the audit or administrative review
25report to the chairperson of the county board of supervisors and the county clerk in

1a county with a single-county department or to the county boards of supervisors and
2the county clerks in counties with a multicounty department, and to the director of
3the county department under s. 46.215, 46.22 or 46.23.
AB150,1063,5 4(2) The county administration of all laws relating to programs under this
5subchapter shall be vested in the officers and agencies designated in the statutes.
AB150, s. 2939 6Section 2939. 49.41 of the statutes is amended to read:
AB150,1063,11 749.41 Assistance grants exempt from levy. All grants of aid to families with
8dependent children, payments made for social services, cash benefits paid by
9counties under s. 59.07 (154),
and benefits under ss. 49.032, 49.046 and s. 49.177 or
10federal Title XVI, are exempt from every tax, and from execution, garnishment,
11attachment and every other process and shall be inalienable.
****Note: This is reconciled s. 49.41. This Section has been affected by drafts with the
following LRB numbers: -1701/3 and -2153/1.
AB150, s. 2940 12Section 2940. 49.41 of the statutes, as affected by 1995 Wisconsin Act .... (this
13act), is renumbered 49.96 and amended to read:
AB150,1063,18 1449.96 Assistance grants exempt from levy. All grants of aid to families with
15dependent children, payments made for social services, cash benefits paid by
16counties under s. 59.07 (154), and benefits under s. 49.177 49.77 or federal Title XVI,
17are exempt from every tax, and from execution, garnishment, attachment and every
18other process and shall be inalienable.
****Note: This is reconciled s. 49.41. This Section has been affected by drafts with the
following LRB numbers: -1701/3 and -2153/1.
AB150, s. 2941 19Section 2941. Subchapter IV (title) of chapter 49 [precedes 49.43] of the
20statutes is created to read:
AB150,1063,2121 Chapter 49
AB150,1064,2
1Subchapter IV
2 Medical assistance
AB150, s. 2942 3Section 2942. The unnumbered subchapter title preceding 49.43 of the
4statutes is repealed.
****Note: This is the reconciled unnumbered subchapter title preceding s. 49.43. This
Section has been affected by drafts with the following LRB numbers: -1701/3 and -2153/1.
AB150, s. 2943 5Section 2943. 49.43 (1) of the statutes is renumbered 49.43 (1m).
AB150, s. 2944 6Section 2944. 49.43 (3e) of the statutes is created to read:
AB150,1064,77 49.43 (3e) "Department" means the department of health and social services.
AB150, s. 2945 8Section 2945. 49.43 (10) of the statutes is amended to read:
AB150,1064,129 49.43 (10) "Provider" means a person, corporation, limited liability company,
10partnership, unincorporated business or professional association and any agent or
11employe thereof who provides medical assistance under ss. 49.45 to 49.47, 49.49 and
1249.495
.
AB150, s. 2946 13Section 2946. 49.43 (10s) of the statutes is created to read:
AB150,1064,1414 49.43 (10s) "Secretary" means the secretary of health and social services.
AB150, s. 2947 15Section 2947. 49.45 (2) (a) 15. of the statutes is amended to read:
AB150,1064,1816 49.45 (2) (a) 15. Routinely provide notification to persons eligible for medical
17assistance under ss. 49.46 to 49.47, or such persons' guardians, of the department's
18access to provider records.
AB150, s. 2948 19Section 2948. 49.45 (2) (a) 22. of the statutes is repealed.
AB150, s. 2949 20Section 2949. 49.45 (2) (a) 23. of the statutes is created to read:
AB150,1065,221 49.45 (2) (a) 23. Promulgate rules that define "supportive services", "personal
22services" and "nursing services" provided in an assisted living facility, as defined

1under s. 50.02 (1d), for purposes of reimbursement under ss. 46.27 (11) (c) 7. and
246.277 (5) (e).
AB150, s. 2950 3Section 2950. 49.45 (2) (b) 4. of the statutes is amended to read:
AB150,1065,74 49.45 (2) (b) 4. Audit claims filed by any provider of medical assistance, and as
5part of that audit, request of any such provider, and review, medical records of
6individuals who have received benefits under the medical assistance program, or
7under s. 49.046
.
AB150, s. 2951 8Section 2951. 49.45 (3) (a) of the statutes is amended to read:
AB150,1065,139 49.45 (3) (a) Reimbursement shall be made to each county department under
10ss. 46.215, 46.22 and 46.23 for the administrative services performed in the medical
11assistance program on the basis of s. 49.52 49.33 (8). For purposes of reimbursement
12under this paragraph, assessments completed under s. 46.27 (6) (a) are
13administrative services performed in the medical assistance program.
AB150, s. 2952 14Section 2952. 49.45 (3) (cm) of the statutes is created to read:
AB150,1065,1915 49.45 (3) (cm) 1. In this paragraph, "best price" means, with respect to any
16service, the lowest price that a provider has accepted or agreed to accept as payment
17from any 3rd-party payer, including medicare, a self-insured plan and an insurer,
18as defined under s. 600.03 (27), for a like service provided to a customer during the
19same month that the service is provided.
AB150,1065,2320 2. Except as provided in subd. 4., the department may require, as a condition
21of reimbursement, that providers of services charge the department the lesser of the
22following when claiming reimbursement for medical assistance services, unless a
23different price is set by contract:
AB150,1065,2424 a. The provider's best price for the service.
AB150,1065,2525 b. The provider's actual cost for the service.
AB150,1066,2
13. When a provider is required to charge the department a price under subd.
22., the department may not reimburse the provider for more than that amount.
AB150,1066,43 4. This paragraph does not apply to services under s. 49.46 (2) (a) 4. a., b., or
4c., (b) 6. e. or 8.
AB150, s. 2953 5Section 2953. 49.45 (5) of the statutes is amended to read:
AB150,1066,96 49.45 (5) Appeal. Any person whose application for medical assistance is
7denied or is not acted upon promptly or who believes that the payments made in the
8person's behalf have not been properly determined may file an appeal with the
9department pursuant to s. 49.50 (8) 49.21 (1).
AB150, s. 2954 10Section 2954. 49.45 (5m) (a) of the statutes is amended to read:
AB150,1066,1711 49.45 (5m) (a) Notwithstanding sub. (3) (e), from the appropriations under s.
1220.435 (1) (b) and (o) the department shall distribute not more than $2,256,000 in
13each of fiscal years 1993-94 and 1994-95 year, to provide supplemental funds to
14rural hospitals that, as determined by the department, have high utilization of
15inpatient services by patients whose care is provided from governmental sources,
16except that the department may not distribute funds to a rural hospital to the extent
17that the distribution would exceed any limitation under 42 USC 1396b (i) (3).
AB150, s. 2955 18Section 2955. 49.45 (6b) (a) of the statutes is amended to read:
AB150,1066,2119 49.45 (6b) (a) Beginning in fiscal year 1994-95 1995-96, for relocations from
20the central Wisconsin center for the developmentally disabled, by $55.77 $232 per
21day.
AB150, s. 2956 22Section 2956. 49.45 (6b) (b) of the statutes is amended to read:
AB150,1066,2523 49.45 (6b) (b) Beginning in fiscal year 1994-95 1995-96, for relocations from
24the northern Wisconsin center for the developmentally disabled, by $49.06 $225 per
25day.
AB150, s. 2957
1Section 2957. 49.45 (6b) (c) of the statutes is amended to read:
AB150,1067,42 49.45 (6b) (c) Beginning in fiscal year 1994-95 1995-96, for relocations from
3the southern Wisconsin center for the developmentally disabled, by $48.37 $173 per
4day.
AB150, s. 2958 5Section 2958. 49.45 (6c) (d) 1. of the statutes is amended to read:
AB150,1067,256 49.45 (6c) (d) 1. No payment may be made under sub. (6m) to a facility or to
7an institution for mental diseases for the care of an individual who is otherwise
8eligible for medical assistance under s. 49.46 or 49.47, who has developmental
9disability or mental illness and for whom under par. (b) or (c) it is determined that
10he or she does not need facility care, unless it is determined that the individual
11requires active treatment for developmental disability or active treatment for
12mental illness and has continuously resided in a facility or institution for mental
13diseases for at least 30 months prior to the date of the determination. If that
14individual requires active treatment and has so continuously resided, he or she shall
15be offered the choice of receiving active treatment for developmental disability or
16active treatment for mental illness in the facility or institution for mental diseases
17or in an alternative setting. A facility resident who has developmental disability or
18mental illness, for whom under par. (c) it is determined that he or she does not need
19facility care and who has not continuously resided in a facility for at least 30 months
20prior to the date of the determination, may not continue to reside in the facility after
21December 31, 1993, and shall, if the department so determines, be relocated from the
22facility after March 31, 1990, and before December 31, 1993. The county department
23shall be responsible for securing alternative residence on behalf of an individual who
24is required to be relocated from a facility under this subdivision, and the facility shall
25cooperate with the county department in the relocation.
AB150, s. 2959
1Section 2959. 49.45 (6c) (d) 2. of the statutes is amended to read:
AB150,1068,82 49.45 (6c) (d) 2. Payment may be made under sub. (6m) to a facility or
3institution for mental diseases for the care of an individual who is otherwise eligible
4for medical assistance under s. 49.46 or 49.47 and who has developmental disability
5or mental illness and is determined under par. (b) or (c) to need facility care,
6regardless of whether it is determined under par. (b) or (c) that the individual does
7or does not require active treatment for developmental disability or active treatment
8for mental illness.
AB150, s. 2960 9Section 2960. 49.45 (6m) (ag) 3m. of the statutes is amended to read:
AB150,1068,1410 49.45 (6m) (ag) 3m. For state fiscal year 1993-94 1995-96, rates that shall be
11set by the department based on information from cost reports for the 1992 1994 fiscal
12year of the facility and for state fiscal year 1994-95 1996-97, rates that shall be set
13by the department based on information from cost reports for the 1993 1995 fiscal
14year of the facility.
AB150, s. 2961 15Section 2961. 49.45 (6m) (ag) 8. of the statutes is amended to read:
AB150,1069,216 49.45 (6m) (ag) 8. Calculation of total payments and supplementary payments
17to facilities that permits an increase in funds allocated under s. 20.435 (1) (b) and (o)
18for nursing home care provided medical assistance recipients over that paid for
19services provided in state fiscal year 1992-93 1994-95 of no more than 3.58% 4.25%
20during state fiscal year 1993-94 1995-96 and over that paid for services provided in
21state fiscal year 1993-94 1995-96 of no more than 3.57% 5% during state fiscal year
221994-95 1996-97, excluding increases in total payments attributable to increases in
23recipient utilization of facility care, payments for the provision of active treatment
24to facility residents with developmental disability or chronic mental illness and

1payments for preadmission screening of facility applicants and annual reviews of
2facility residents required under 42 USC 1396r (e).
AB150, s. 2962 3Section 2962. 49.45 (6m) (am) 5. of the statutes is amended to read:
AB150,1069,74 49.45 (6m) (am) 5. Allowable administrative and general costs, including costs
5related to the facility's overall management and administration and allowable
6expenses that are not recognized or reimbursed in other cost centers and including
7the costs of commercial estimators approved by the department under par. (ar) 6
.
AB150, s. 2963 8Section 2963. 49.45 (6m) (am) 5m. of the statutes is created to read:
AB150,1069,119 49.45 (6m) (am) 5m. Allowable interest expense of the facility, less interest
10income of the facility and less interest income of affiliated entities, to the extent
11required under the approved state plan for services under 42 USC 1396.
AB150, s. 2964 12Section 2964. 49.45 (6m) (ar) 1. c. of the statutes is amended to read:
AB150,1069,1813 49.45 (6m) (ar) 1. c. If a facility has an approved program for provision of
14service to emotionally disturbed or mentally retarded residents, residents dependent
15upon ventilators, or residents requiring supplemental skilled care due to complex
16medical conditions, a supplement to the direct care component of the facility rate
17under subd. 1. b. may be made to that facility according to a method developed by the
18department.
AB150, s. 2965 19Section 2965. 49.45 (6m) (ar) 6. of the statutes is amended to read:
AB150,1069,2520 49.45 (6m) (ar) 6. Capital payment shall be based on a replacement value for
21a facility, as. The replacement value shall be determined by a commercial estimator
22with which contracted for by the department has contracted for service, and paid for
23by the facility. The replacement value shall be
subject to limitations determined by
24the department, except that the department may not reduce final capital payment
25of a facility by more than $3.50 per patient day.
AB150, s. 2966
1Section 2966. 49.45 (6m) (av) 2. of the statutes is amended to read:
AB150,1070,62 49.45 (6m) (av) 2. The department shall compile an average payment rate for
3each facility based on that facility's rates for cost centers described under par. (am)
41. to 5. that were in effect on June 30 of the previous year, 1994. The department may
5develop a method for adjusting the facility's rate for the cost center under par. (am)
61. in compiling the average payment rate under this subdivision.
AB150, s. 2967 7Section 2967. 49.45 (6m) (av) 4. of the statutes is amended to read:
AB150,1070,128 49.45 (6m) (av) 4. If the facility's payment rate under subd. 1. is a decrease from
9its average payment rate from the previous year under subd. 2., and if the figure
10calculated under subd. 3. exceeds the payment rate for the facility under subd. 1., the
11facility's average payment rate shall be the greater of its average payment rate under
12subd. 2. or its rate under subd. 1.
AB150, s. 2968 13Section 2968. 49.45 (6m) (bm) 4. of the statutes is repealed.
AB150, s. 2969 14Section 2969. 49.45 (6m) (br) 1. of the statutes is amended to read:
AB150,1070,2115 49.45 (6m) (br) 1. Notwithstanding s. 20.435 (1) (cb), (3) (cd), (4) (de) or (eb) or
16(7) (b) or 20.445 (3) (de), the department shall reduce allocations of funds to counties
17in the amount of the disallowance from the appropriations under s. 20.435 (1) (cb),
18(3) (cd), (4) (de) or (eb) or (7) (b), or the department shall direct the department of
19industry, labor and human relations to reduce allocations of funds to counties in the
20amount of the disallowance from the appropriation under s. 20.445 (3) (de),
in
21accordance with s. 16.544 to the extent applicable.
AB150, s. 2970 22Section 2970. 49.45 (6m) (c) 6. of the statutes is created to read:
AB150,1070,2423 49.45 (6m) (c) 6. Provide, upon request, such information as the department
24considers necessary to determine allowable interest expenses under par. (am) 5m.
AB150, s. 2971 25Section 2971. 49.45 (6m) (h) of the statutes is amended to read:
AB150,1071,6
149.45 (6m) (h) The department may require by rule that all claims for payment
2of services provided facility residents under this chapter subchapter be submitted or
3countersigned by the respective facility administrator. The department may specify
4those categories of services for which payment will be made only if the services are
5rendered or authorized in writing by a primary health care provider designated by
6the recipient for the particular category of services.
AB150, s. 2972 7Section 2972. 49.45 (6m) (i) 1. of the statutes is amended to read:
AB150,1071,118 49.45 (6m) (i) 1. On or after October 1, 1981, unless subd. 1m. or 2. applies,
9medical assistance payment for inpatient nursing care may only be provided for
10persons eligible under s. 49.46 and receiving skilled, intermediate or limited levels
11of nursing care as these levels are defined under s. HSS 132.13, Wis. adm. code.
AB150, s. 2973 12Section 2973. 49.45 (6m) (i) 1m. of the statutes is created to read:
AB150,1071,1813 49.45 (6m) (i) 1m. After December 30, 1995, if a waiver is granted and remains
14in effect as specified in s. 49.47 (6) (am) 2., medical assistance payment for skilled
15nursing services, as specified in s. 49.46 (2) (a) 4. c., and for intermediate care
16services, as specified in s. 49.46 (2) (b) 6. a., may be provided for persons described
17under subd. 1. and for persons who meet the conditions specified in s. 49.47 (6) (am)
181. a. to d.
AB150, s. 2974 19Section 2974. 49.45 (6m) (L) of the statutes is created to read:
AB150,1071,2420 49.45 (6m) (L) For purposes of ss. 46.27 (11) (c) 7. and 46.277 (5) (e), the
21department shall, by July 1 annually, , determine the statewide reimbursement rate
22under this subsection and submit the figure to the department of administration for
23review. The department of administration shall approve the rate before the rate may
24be used under s. 46.27 (11) (c) 7. or 46.277 (5) (e).
AB150, s. 2975 25Section 2975. 49.45 (6t) of the statutes is created to read:
AB150,1072,7
149.45 (6t) County department operating deficit reduction. From the
2appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined
3under criteria developed by the department, incurred by a county department under
4s. 46.215, 46.22 or 46.23 for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f.,
5the department shall allocate up to $4,500,000 in each fiscal year to these county
6departments, as determined by the department, and shall perform all of the
7following:
AB150,1072,118 (a) For the reduction of operating deficits incurred by the county departments,
9estimate the availability of federal medicaid funds that may be matched to county
10funds that are expended for costs in excess of reimbursement for services provided
11under s. 49.46 (2) (a) 4. d. and (b) 6. f.
AB150,1072,1512 (b) Based on the amount estimated to be available under par. (a), develop a
13method, which need not be promulgated as rules under ch. 227, to distribute this
14allocation to the individual county departments under s. 46.215, 46.22 or 46.23 that
15have incurred operating deficits that shall include all of the following:
AB150,1072,1616 1. Development of criteria for determining operating deficits.
AB150,1072,1817 2. Agreement, by the county in which is located a county department that has
18an operating deficit, to provide funds to match federal medicaid funds.
AB150,1072,1919 3. Consideration of the size of a county department's operating deficit.
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