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 […]
49.473 – Medical assistance; women diagnosed with breast or cervical cancer or precancerous conditions.
49.473 Medical assistance; women diagnosed with breast or cervical cancer or precancerous conditions. (1) In this section: (a) “County department” means a county department under s. 46.215, 46.22, or 46.23. (b) “Qualified entity” has the meaning given in 42 USC 1396r-1b (b) (2). (2) A woman is eligible for medical assistance as provided under sub. […]
49.475 – Information about assistance program beneficiaries; electronic submission of claims.
49.475 Information about assistance program beneficiaries; electronic submission of claims. (1) Definitions. In this section: (ar) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a). (b) “Insurer” has the meaning given in s. 600.03 (27). (c) “Pharmacy benefits management” means the administration or management of prescription drug benefits provided by an insurer […]
49.48 – Denial, nonrenewal and suspension of certification of service providers based on certain delinquency in payment.
49.48 Denial, nonrenewal and suspension of certification of service providers based on certain delinquency in payment. (1) Except as provided in sub. (1m), the department shall require each applicant to provide the department with the applicant’s social security number, if the applicant is an individual, as a condition of issuing or renewing a certification 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 […]