AB40,560,1917 49.45 (30g) (a) 3. The individual, the community recovery services, and the
18community recovery services provider meet any condition set forth in the approved
19amendment to the medical assistance plan submitted under 42 USC 1396n (i).

AB40,561,221 49.453 (2) (a) Institutionalized individuals. (intro.) Except as provided in sub.
22(8), if an institutionalized individual or his or her spouse, or another person acting
23on behalf of the institutionalized individual or his or her spouse, transfers assets;
24regardless of whether those assets, if retained, are excluded under 42 USC 1396p;
25for less than fair market value on or after the institutionalized individual's look-back

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1date, the institutionalized individual is ineligible for medical assistance for the
2following services for the period specified under sub. (3):

AB40,561,104 49.453 (2) (b) Noninstitutionalized individuals. (intro.) Except as provided in
5sub. (8), if a noninstitutionalized individual or his or her spouse, or another person
6acting on behalf of the noninstitutionalized individual or his or her spouse, transfers
7assets; regardless of whether those assets, if retained, are excluded under 42 USC
81396p; for less than fair market value on or after the noninstitutionalized
9individual's look-back date, the noninstitutionalized individual is ineligible for
10medical assistance for the following services for the period specified under sub. (3):

AB40,561,1312 49.453 (3) (a) (intro.) The period of ineligibility under this subsection begins
13on either of the following for an applicant for Medical Assistance:

AB40,561,1815 49.453 (3) (ag) The period of ineligibility under this subsection for a transfer
16of assets made at the time the individual is receiving long-term care services through
17Medical Assistance begins on the first day of the month following the month in which
18the individual receives advance notice of the period of ineligibility.

AB40,561,2320 49.453 (4c) (c) A promissory note in which the debtor is a presumptive heir of
21the lender or in which neither the lender nor debtor has any incentive to enforce
22repayment is considered cancelled upon the death of the lender for purposes of this
23section.

AB40,562,5

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149.453 (8) (a) 1. The assets are exempt under 42 USC 1396p (c) (2) (A), (B), or
2(C). To make a satisfactory showing to the state under 42 USC 1396p (c) (2) (C) and
3adjust the ineligibility period under sub. (3), the individual shall demonstrate that
4all of the assets transferred for less than fair market value, or cash equal to the value
5of the assets transferred for less than fair market, have been returned to him or her.

AB40,562,77 49.455 (5) (title) Rules for treatment of resources; ineligibility.

AB40,562,159 49.455 (5) (d) During a continuous period of institutionalization, after an
10institutionalized spouse is determined to be eligible for medical assistance, no
11resources of the community spouse are considered to be available to the
12institutionalized spouse, except that a transfer of those resources or other assets by
13the community spouse within the first 5 years of eligibility of the institutionalized
14spouse may result in a period of ineligibility under s. 49.453 (2) and (3) for the
15institutionalized spouse.

AB40,562,2117 49.455 (5) (e) The department may deny to the institutionalized spouse
18eligibility for Medical Assistance if, when requested by the department, the
19institutionalized spouse and the community spouse do not provide the total value of
20their assets and information on income and resources to the extent required under
21federal Medicaid law or sign the application for Medical Assistance.

AB40,563,624 49.455 (8) (d) 1. If either spouse establishes at a fair hearing that the
25community spouse resource allowance determined under sub. (6) (b) 1. to 2. or 4.

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1without a fair hearing does not generate enough income to raise the community
2spouse's income to the minimum monthly maintenance needs allowance under sub.
3(4) (c), the department shall establish, under subd. 2., an amount to be used under
4sub. (6) (b) 3. that results in a community spouse resource allowance that generates
5enough income to raise the community spouse's income to the minimum monthly
6maintenance needs allowance under sub. (4) (c).

AB40,563,18 73. Except in exceptional cases which would result in financial duress for the
8community spouse, the department may not establish an amount to be used under
9sub. (6) (b) 3. unless the institutionalized spouse makes available to the community
10spouse the maximum monthly income allowance permitted under sub. (4) (b) or, if
11the institutionalized spouse does not have sufficient income to make available to the
12community spouse the maximum monthly income allowance permitted under sub.
13(4) (b), unless the institutionalized spouse makes all of his or her income, except for
14an amount equal to the sum of the personal needs allowance under sub. (4) (a) 1. and
15any family allowances under sub. (4) (a) 3. paid by the institutionalized spouse and
16the amount incurred as expenses for medical or remedial care for the
17institutionalized spouse under sub. (4) (a) 4., available to the community spouse as
18a community spouse monthly income allowance under sub. (4) (b).

AB40,564,320 49.455 (8) (d) 2. The department shall base the amount to be used under sub.
21(6) (b) 3. on the cost of a single premium lifetime annuity that pays monthly amounts
22that, combined with other available income, raises the community spouse's income
23to the minimum monthly maintenance needs allowance. Any resource, regardless
24of whether the resource generates income, may be transferred in an amount that,
25combined with the community spouse resource allowance calculated before the fair

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1hearing, provides the community spouse with sufficient funds to purchase the
2annuity. The community spouse is not required to purchase an annuity to obtain this
3amount.

AB40,564,85 49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the
6income and resource eligibility requirements for the federal Supplemental Security
7Income program under 42 USC 1381 to 1383d. For purposes of this subdivision,
8"income" has the meaning given for "family income" in s. 49.471 (1) (f).

AB40,564,1410 49.46 (1) (am) 1. a. A pregnant woman whose family income, before any income
11is disregarded under this paragraph, does not exceed, in state fiscal year 1994-95,
12155% of the poverty line for a family the size of the woman's family; and, in each state
13fiscal year after the 1994-95 state fiscal year, 185% 133 percent of the poverty line
14for a family the size of the woman's family.

AB40,564,2016 49.46 (1) (c) (intro.) Except as provided under par. (co) or (cr), a family that
17becomes ineligible for aid to families with dependent children under s. 49.19 because
18of increased income from employment or increased hours of employment or because
19of the expiration of the time during which the disregards under s. 49.19 (5) (a) 4. or
204m. or (am) apply shall receive medical assistance for:

AB40,565,422 49.46 (1) (cg) Medical Except as provided under par. (cr), medical assistance
23shall be provided to a dependent child, a relative with whom the child is living or the
24spouse of the relative, if the spouse meets the requirements of s. 49.19 (1) (c) 2. a. or
25b., for 4 calendar months beginning with the month in which the child, relative or

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1spouse is ineligible for aid to families with dependent children because of the
2collection or increased collection of maintenance or support, if the child, relative or
3spouse received aid to families with dependent children in 3 or more of the 6 months
4immediately preceding the month in which that ineligibility begins.

AB40,565,136 49.46 (1) (co) 1. Except as provided under subd. 2. or par. (cr), medical
7assistance shall be provided to a family for 12 consecutive calendar months following
8the month in which the family becomes ineligible for aid to families with dependent
9children because of increased income from employment, because the family no longer
10receives the earned income disregard under s. 49.19 (5) (a) 4. or 4m. or (am) due to
11the expiration of the time limit during which the disregards are applied or because
12of the application of the monthly employment time eligibility limitation under 45
13CFR 233.100 (a) (1) (i).

AB40,565,1815 49.46 (1) (co) 2. If a waiver under subd. 3. is granted and except as provided
16in par. (cr), the department may select individuals to receive medical assistance
17benefits as provided under par. (c), rather than under subd. 1., as a control group for
18part or all of the period during which the waiver is in effect.

AB40,565,2420 49.46 (1) (cr) To the extent approved by the federal department of health and
21human services, an individual or family described in par. (c), (cg), or (co) is not eligible
22for Medical Assistance if the federal department of health and human services
23approves a request from the department to deny all or some transitional Medical
24Assistance benefits to that individual or family, if approval is required.

AB40,566,7

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149.46 (1) (em) For purposes of determining the eligibility and any cost-sharing
2requirements of an individual under par. (a) 6m., 14., or 14m., (d) 2., or (e), to the
3extent approved by the federal government, the department shall exclude any assets
4accumulated in an independence account, as defined in s. 49.472 (1) (c), and any
5income or assets from retirement benefits earned or accumulated from employment
6income or employer contributions while the individual was employed and eligible for
7and receiving medical assistance under s. 49.472.

AB40,566,119 49.46 (2) (b) 19. Subject to par. (br), services provided by early intervention
10teachers, home trainers, parent-to-parent mentors, and developmental specialists
11to children in the benchmark plan under par. (br).

AB40,566,1513 49.46 (2) (b) 20. Subject to s. 49.45 (24j), any additional services, as determined
14by the department, that are targeted to a population enrolled in a medical home
15initiative under s. 49.45 (24j).

AB40,566,1917 49.46 (2) (bc) Subject to s. 49.45 (24j), the department may provide any of the
18services described in par. (a) or (b) through a medical home initiative under s. 49.45
19(24j).

AB40,567,321 49.46 (2) (br) If the federal department of health and human services approves
22the department's request to offer a benchmark plan under this paragraph, the
23department may enroll any child who is receiving services through the early
24intervention program under s. 51.44 in a benchmark plan under this paragraph. The
25department may not require a child who is receiving services through the early

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1intervention program under s. 51.44 to enroll in a benchmark plan offered under this
2paragraph. The department may not charge a copayment to a child who is enrolled
3in the benchmark plan under this paragraph for services described in par. (b) 19.

AB40,567,125 49.468 (1) (d) Benefits under par. (b) or (c) are available for an individual who
6has resources that are equal to or less than 200% of the allowable resources as
7determined under 42 USC 1381 to 1385, excluding, to the extent approved by the
8federal government, any assets accumulated in an independence account, as defined
9in s. 49.472 (1) (c), and any income or assets from retirement benefits earned or
10accumulated from income or employer contributions while the individual was
11employed and eligible for and receiving medical assistance under s. 49.472, and who
12has income that is equal to or less than 100% of the poverty line.

AB40,567,2214 49.468 (1m) (b) Benefits under par. (a) are available for an individual who has
15resources that are equal to or less than 200% of the allowable resources determined
16under 42 USC 1381 to 1385, excluding, to the extent approved by the federal
17government, any assets accumulated in an independence account, as defined in s.
1849.472 (1) (c), and any income or assets from retirement benefits earned or
19accumulated from income or employer contributions while the individual was
20employed and eligible for and receiving medical assistance under s. 49.472, and who
21has income that is greater than 100% of the poverty line but less than 120% of the
22poverty line.

AB40,568,624 49.468 (2) (b) Benefits under par. (a) are available for an individual who has
25resources that are equal to or less than 200% of the allowable resources under 42

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1USC 1381 to 1385, excluding, to the extent approved by the federal government, any
2assets accumulated in an independence account, as defined in s. 49.472 (1) (c), and
3any income or assets from retirement benefits earned or accumulated from income
4or employer contributions while the individual was employed and eligible for and
5receiving medical assistance under s. 49.472, and who has income that is equal to or
6less than 200% of the poverty line.

AB40,568,118 49.47 (4) (a) 1. Under 21 years of age and resides in an intermediate care
9facility, skilled nursing facility, or inpatient psychiatric hospital. The department
10shall apply the definition of family income in s. 49.471 (1) (f) to make determinations
11of income under this subdivision.

AB40,568,1713 49.47 (4) (am) 1. A pregnant woman whose family income does not exceed 155%
14of the poverty line for a family the size of the woman's family, except that if a waiver
15under par. (j) or a change in the approved state plan under s. 49.46 (1) (am) 2. is in
16effect, the income limit is 185% 133 percent of the poverty line for a family the size
17of the woman's family in each state fiscal year after the 1994-95 state fiscal year.

AB40,569,419 49.47 (4) (b) (intro.) Eligibility exists if the applicant's property, subject to the
20exclusion of excluding any amounts under the Long-Term Care Partnership
21Program established under s. 49.45 (31), and, to the extent approved by the federal
22government, any amounts assets accumulated in an independence account, as
23defined in s. 49.472 (1) (c), or and any income or assets from retirement assets that
24accrued benefits earned or accumulated from employment income or employer
25contributions while the applicant was employed and eligible for the community

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1options program under s. 46.27 (11), or any other Medical Assistance program,
2including deferred compensation or the value of retirement accounts in the
3Wisconsin Retirement System or under the federal Social Security Act and receiving
4medical assistance under s. 49.472, does not exceed the following:

AB40,569,86 49.47 (4) (b) 2w. For a person who is eligible under par. (a) 3. or 4., life insurance
7with cash surrender values if the total face combined cash surrender value of all life
8insurance policies, including riders and other attachments, is not more than $1,500.

AB40,569,2010 49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. 3.,
11eligibility exists if income does not exceed 133 1/3% of the maximum aid to families
12with dependent children payment under s. 49.19 (11) for the applicant's family size
13or the combined benefit amount available under supplemental security income
14under 42 USC 1381 to 1383c and state supplemental aid under s. 49.77 whichever
15is higher lower. In this subdivision "income" includes earned or unearned income
16that would be included in determining eligibility for the individual or family under
17s. 49.19 or 49.77, or for the aged, blind or disabled under 42 USC 1381 to 1385.
18"Income" does not include earned or unearned income which would be excluded in
19determining eligibility for the individual or family under s. 49.19 or 49.77, or for the
20aged, blind or disabled individual under 42 USC 1381 to 1385.

AB40,569,2523 49.471 (1) (cm) "Disabled" means, when referring to an adult, meeting the
24disability standard for eligibility for federal supplemental security income under 42
25USC 1382c (a) (3).

AB40,570,42 49.471 (1) (f) "Family income" means the total gross earned and unearned
3income received by all members of a family has the meaning given for "household
4income" under 42 CFR 435.603 (d).

AB40,570,76 49.471 (1) (k) 5. d. The mother's family income exceeds 133 percent of the
7poverty line.

AB40,570,119 49.471 (4) (a) (intro.) Except as otherwise provided in this section, all of the
10following individuals are eligible for the benefits described in s. 49.46 (2) (a) and (b),
11subject to sub. (6) (k) and s. 49.45 (24j):

AB40,570,1413 49.471 (4) (a) 1. A pregnant woman whose family income does not exceed 200
14133 percent of the poverty line.

AB40,570,2516 49.471 (4) (a) 4. a. The individual is a parent or caretaker relative of a
17dependent child who is living in the home with the parent or caretaker relative or
18who is temporarily absent from the home for not more than 6 months or, if the
19dependent child has been removed from the home for more than 6 months, the parent
20or caretaker relative is working toward unifying the family by complying with a
21permanency plan under s. 48.38 or 938.38. For purposes of this subdivision, a
22"dependent child" means an individual who is under the age of 18 or an individual
23who is age 18 and a full-time student in secondary school or equivalent vocational
24or technical training if before attaining the age of 19 the individual is reasonably
25expected to complete the school or training.

AB40,571,52 49.471 (4) (a) 4. b. Except as provided in subd. 4. c., the The individual's family
3income does not exceed 200 100 percent of the poverty line and does not include
4self-employment income before application of the 5 percent income disregard under
542 CFR 435.603 (d).

AB40,571,158 49.471 (4) (a) 5. An individual who, regardless of family income, was born on
9or after January 1, 1990 1988, and who, on his or her 18th birthday, was in a foster
10care placement under the responsibility of a this state, or at the option of the
11department, under the responsibility of another state, and enrolled in Medical
12Assistance under this subchapter or a Medicaid program, as determined by the
13department. The coverage for an individual under this subdivision ends on the last
14day of the month in which the individual becomes 21 26 years of age, unless he or she
15otherwise loses eligibility sooner.

AB40,571,1917 49.471 (4) (a) 7. Individuals who qualify for a medical assistance eligibility
18extension under s. 49.46 (1) (c), (cg), or (co) when their income increases above the
19poverty line, except as provided in s. 49.46 (1) (cr).