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 of the statutes is repealed.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.
AB150,1072,2120 (c) Except as provided in par. (d), distribute the allocation under the
21distribution method that is developed.
AB150,1073,222 (d) If the federal department of health and human services approves for state
23expenditure in a fiscal year amounts under s. 20.435 (1) (o) that result in a lesser
24allocation amount than that allocated under this subsection or disallows use of the

1allocation of federal medicaid funds under par. (c), reduce allocations under this
2subsection and distribute on a prorated basis, as determined by the department.
AB150, s. 2976 3Section 2976. 49.45 (6u) (intro.) of the statutes is amended to read:
AB150,1073,104 49.45 (6u)Facility operating deficit reduction. (intro.) Except as provided
5in par. (g), from the appropriation under s. 20.435 (1) (o), for reduction of operating
6deficits, as defined under criteria developed by the department, incurred by a facility,
7as defined under sub. (6m) (a) 2., that is established under s. 49.14 (1) 49.70 (1) or
8that is owned and operated by a city, village or town, the department shall distribute
9to these facilities not more than $18,600,000 in each fiscal year, as determined by the
10department, and shall perform all of the following:
AB150, s. 2977 11Section 2977. 49.45 (6u) (b) 2. of the statutes is amended to read:
AB150,1073,1612 49.45 (6u) (b) 2. Agreement by the county in which is located the facility
13established under s. 49.14 (1) 49.70 (1) and agreement by the city, village or town that
14owns and operates the facility that the applicable county, city, village or town shall
15provide funds to match federal medical assistance matching funds under this
16subsection.
AB150, s. 2978 17Section 2978. 49.45 (6u) (b) 2m. of the statutes is amended to read:
AB150,1073,2118 49.45 (6u) (b) 2m. Identification by the county in which is located the facility
19established under s. 49.14 (1) 49.70 (1) of all county funds expended in each calendar
20year to operate the facility, and certification by the county to the department of this
21amount.
AB150, s. 2979 22Section 2979. 49.45 (6v) of the statutes is repealed.
AB150, s. 2980 23Section 2980. 49.45 (6w) (intro.) of the statutes is amended to read:
AB150,1074,524 49.45 (6w) Hospital operating deficit reduction. (intro.) From the
25appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined

1under criteria developed by the department, incurred by a hospital, as defined under
2s. 50.33 (2) (a) and (b), that is operated by the state, established under s. 49.16 or
3owned and operated by a city or village, the department shall allocate distribute,
4beginning July 1, 1996,
up to $3,300,000 $8,500,000 in each fiscal year to these
5hospitals, as determined by the department, and shall perform all of the following:
AB150, s. 2981 6Section 2981 . 49.45 (6w) (intro.) of the statutes, as affected by 1995 Wisconsin
7Act .... (this act), is amended to read:
AB150,1074,148 49.45 (6w)Hospital operating deficit reduction. (intro.) From the
9appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined
10under criteria developed by the department, incurred by a hospital, as defined under
11s. 50.33 (2) (a) and (b), that is operated by the state, established under s. 49.16 49.71
12or owned and operated by a city or village, the department shall distribute, beginning
13July 1, 1996, up to $8,500,000 in each fiscal year to these hospitals, as determined
14by the department, and shall perform all of the following:
****Note: This is reconciled s. 49.45 (6w) (intro.). This Section has been affected by drafts
with the following LRB numbers: -2153/1 and -2413/2.
AB150, s. 2982 15Section 2982. 49.45 (6w) (a) 2. of the statutes is amended to read:
AB150,1074,1616 49.45 (6w) (a) 2. County funds, for a hospital established under s. 49.16 49.71.
AB150, s. 2983 17Section 2983. 49.45 (6w) (b) 2. b. of the statutes is amended to read:
AB150,1074,1918 49.45 (6w) (b) 2. b. Agreement to provide matching funds by the county in
19which is located a hospital established under s. 49.16 49.71.
AB150, s. 2984 20Section 2984. 49.45 (6x) (a) of the statutes is amended to read:
AB150,1075,321 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriations under s.
2220.435 (1) (b) and (o) the department shall distribute not more than $4,748,000 in
23each of fiscal years 1993-94 and 1994-95 year, to provide funds to an essential access

1city hospital, except that the department may not allocate funds to an essential
2access city hospital to the extent that the allocation would exceed any limitation
3under 42 USC 1396b (i) (3).
AB150, s. 2985 4Section 2985. 49.45 (6y) (a) of the statutes is amended to read:
AB150,1075,105 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriations under s.
620.435 (1) (b) and (o) the department shall distribute funding in each fiscal year to
7provide supplemental payment to county hospitals and to county mental health
8complexes, as determined by the department, for inpatient hospital services that are
9not in excess of the hospitals' customary charges for the services, as limited under
1042 USC 1396b (i) (3).
AB150, s. 2986 11Section 2986. 49.45 (7) (d) 4. of the statutes is amended to read:
AB150,1075,1512 49.45 (7) (d) 4. The department's determination of serious misconduct under
13this subsection shall be cause for terminating the facility's participation in the
14state-funded portion of the medical assistance program under ss. 49.45 to 49.47 this
15subchapter
.
AB150, s. 2987 16Section 2987. 49.45 (8) (title) of the statutes is amended to read:
AB150,1075,1817 49.45 (8) (title) Home Per-visit limits on home health services
18reimbursement.
AB150, s. 2988 19Section 2988. 49.45 (8e) of the statutes is created to read:
AB150,1075,2420 49.45 (8e) Monthly limits on home health, and private-duty nursing services
21reimbursement.
(a) Except as provided in par. (b), reimbursement under s. 20.435
22(1) (b) and (o) for home health and private-duty nursing services provided to a
23medical assistance recipient in a month may not exceed the average monthly cost of
24nursing home care, as determined by the department.
AB150,1075,2525 (b) This subsection does not apply to any of the following:
AB150,1076,1
11. A medical assistance recipient under the age of 22.
AB150,1076,32 2. A ventilator-dependent individual under s. 49.46 (2) (b) 6. m. or 49.47 (6) (a)
31.
AB150,1076,74 3. An individual not covered under subds. 1. and 2., if the department
5determines that the cost of providing the individual with nursing home care would
6exceed the cost of providing the individual with home health and private-duty
7nursing services.
****Note: This is reconciled s. 49.45 (8e). It has been affected by drafts with the following
LRB numbers: -1137/2 and-2408/1.
AB150, s. 2989 8Section 2989. 49.45 (8m) (intro.) of the statutes is amended to read:
AB150,1076,149 49.45 (8m)Rates for respiratory care services. (intro.) Notwithstanding a
10determination by the department of a maximum rate
the limits under sub. subs. (8)
11and (8e), the rates under sub. (8) and rates charged by providers under s. 49.46 (2)
12(a) 4. d. that are not home health agencies, for reimbursement for respiratory care
13services for ventilator-dependent individuals under ss. 49.46 (2) (b) 6. m. and 49.47
14(6) (a) 1., shall be as follows:
AB150, s. 2990 15Section 2990. 49.45 (11) of the statutes is amended to read:
AB150,1076,1816 49.45 (11) Penalty. Any person who receives or assists another in receiving
17assistance under this section, to which the recipient is not entitled, shall be subject
18to the penalties under s. 49.12 49.95.
****Note: This is reconciled s. 49.45 (11). This Section has been affected by drafts with the
following LRB numbers: -1701/3 and -2153/1.
AB150, s. 2991 19Section 2991. 49.45 (12) (c) of the statutes is amended to read:
AB150,1077,420 49.45 (12) (c) The department shall request proposals for a system of
21machine-readable identification cards for medical assistance recipients and a
22computerized support system for the cards that will accept and respond to

1electronically conveyed requests from health care providers for information related
2to medical assistance recipients, such as eligibility, coverages and authorizations.
3The request for proposals shall specify that the systems are to be operating by
4January 1, 1996 1997.
AB150, s. 2992 5Section 2992. 49.45 (24m) (a) of the statutes is amended to read:
AB150,1077,96 49.45 (24m) (a) By September 1, 1990, select a county in this state and solicit
7bids from providers of home health care and personal care services in that county for
8the provision, on a contractual basis, of home health and personal care services
9authorized under ss. 49.46 (2) (a) 4. d. and (b) 6. j. and 49.47 (6) (a) 1.
AB150, s. 2993 10Section 2993. 49.45 (25) (am) of the statutes is renumbered 49.45 (25) (am)
11(intro.) and amended to read:
AB150,1077,1712 49.45 (25) (am) (intro.) Except as provided under pars. (be) and (bg) and sub.
13(24), case management services under s. 49.46 (2) (b) 9. and (bm) are reimbursable
14under medical assistance only if provided to a medical assistance beneficiary who
15receives case management services from or through a certified case management
16provider in a county, city, village or town that elects, under par. (b), to make the
17services available and who has meets at least one of the following conditions:
AB150,1077,18 181. Has a developmental disability, as defined under s. 51.01 (5) (a),.
AB150,1077,19 192. Has a chronic mental illness, as defined under s. 51.01 (3g), or.
AB150,1077,20 203. Has Alzheimer's disease, as defined under s. 46.87 (1) (a), is.
AB150,1077,21 214. Is an alcoholic, as defined under s. 51.01 (1) , or.
AB150,1077,22 225. Is drug dependent, as defined under s. 51.01 (8), is.
AB150,1077,23 236. Is physically disabled, as defined by the department, is.
AB150,1077,24 247. Is a severely emotionally disturbed child, is.
AB150,1077,25 258. Is age 65 or over or, after December 31, 1991, has.
AB150,1078,1
110. Has HIV infection, as defined in s. 252.01 (2).
AB150, s. 2994 2Section 2994. 49.45 (25) (am) 9. of the statutes is created to read:
AB150,1078,43 49.45 (25) (am) 9. Is a member of a family that has a child who is at risk of
4serious physical, mental or emotional dysfunction, as defined by the department.
AB150, s. 2995 5Section 2995. 49.45 (25) (am) 11. of the statutes is created to read:
AB150,1078,76 49.45 (25) (am) 11. Is a child who is eligible for early intervention services
7under s. 51.44.
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