49.493 – Benefits under uninsured health plans.
49.493 Benefits under uninsured health plans. (1) In this section: (a) “Department or contract provider” means the department, the county providing the medical benefits or assistance or a health maintenance organization that has contracted with the department to provide the medical benefits or assistance. (b) “Medical benefits or assistance” means medical benefits under s. 49.02 […]
49.496 – Recovery of correct medical assistance payments.
49.496 Recovery of correct medical assistance payments. (1) Definitions. In this section: (af) “Decedent” means a deceased recipient or a deceased nonrecipient surviving spouse, whichever is applicable. (ah) “Disabled” has the meaning given in s. 49.468 (1) (a) 1. (b) “Home” means property in which a person has an ownership interest consisting of the person’s […]
49.497 – Recovery of incorrect Medical Assistance or Badger Care payments and of unpaid employer penalties.
49.497 Recovery of incorrect Medical Assistance or Badger Care payments and of unpaid employer penalties. (1) (a) The department may recover any payment made incorrectly for benefits provided under this subchapter or s. 49.665 if the incorrect payment results from any of the following: 1. A misstatement or omission of fact by a person supplying […]
49.498 – Requirements for skilled nursing facilities.
49.498 Requirements for skilled nursing facilities. (1) Definitions. In this section: (a) “Active treatment for developmental disability” means a continuous program for an individual who has a developmental disability that includes aggressive, consistent implementation of specialized and generic training, treatment, health services and related services, that is directed toward the individual’s acquiring behaviors necessary for […]
49.499 – Nursing facility resident protection.
49.499 Nursing facility resident protection. (1) From the appropriation under s. 20.435 (6) (g), the department shall contribute to the payment of all of the following, as needed by a resident in a nursing facility, as defined in s. 49.498 (1) (i), that is in violation of s. 49.498 or of a rule promulgated under […]
49.485 – False claims.
49.485 False claims. Whoever knowingly presents or causes to be presented to any officer, employee, or agent of this state a false claim for medical assistance shall forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the damages that were sustained by the state or would have been sustained […]
49.49 – Medical assistance offenses.
49.49 Medical assistance offenses. (1d) Damages. If any person is convicted under s. 946.91 (2), the state shall have a cause of action for relief against such person in an amount 3 times the amount of actual damages sustained as a result of any excess payments made in connection with the offense for which the […]
49.465 – Presumptive medical assistance eligibility.
49.465 Presumptive medical assistance eligibility. (1) In this section, “qualified provider” means a provider which satisfies the requirements under 42 USC 1396r-1 (b) (2), as determined by the department. (2) A pregnant woman is eligible for medical assistance benefits, as provided under sub. (3), during the period beginning on the day on which a qualified […]
49.468 – Expanded medicare buy-in.
49.468 Expanded medicare buy-in. (1) (a) In this subsection and sub. (1m): 1. “Disabled” means blind, as defined under 42 USC 1382c (a) (2) and disabled, as defined under 42 USC 1382c (a) (3). 2. “Elderly” means 65 years of age or older. 3. “Entitled to coverage under part A of medicare” means eligible for […]
49.47 – Medical assistance; medically indigent.
49.47 Medical assistance; medically indigent. (1) Purpose. Medical assistance as set forth herein shall be provided to persons over 65, if eligible under this section, all disabled children under 18, if eligible under this section, and persons who are blind or disabled, if eligible under this section. (2) Definitions. As used in this section, unless […]