AB 855

This bill subjects certain acts and omissions related to a Parental Choice

Program (PCP) to criminal penalties and changes the family income eligibility level

to up to 133 percent of the federal poverty line (FPL) for parents and caretaker

relatives under BadgerCare Plus (BC+) and for childless adults under BadgerCare

Plus Core (BC+ Core).

Under the bill, intentionally making a false statement or representation in an

application to participate in a PCP is a Class A misdemeanor. The bill makes

concealing or failing to disclose an event with an intent to fraudulently participate

in a PCP or using a payment received under a PCP for an unauthorized purpose

either a Class G or Class H felony, depending on the payment a person received under

the PCP. Additionally, under the bill, a statement in a written application for a PCP

is considered to be an admission of the existence, correctness, or validity of the

statement. This bill authorizes the Department of Justice or a district attorney to

prosecute violations of criminal laws affecting a PCP, including laws affecting the

health, safety, and welfare of pupils attending a private school participating in a PCP.

Currently, the Department of Health Services (DHS) administers the Medical

Assistance (MA) program, which is a joint federal and state program that provides

health services to individuals who have limited financial resources. Some services

are provided through programs that operate under a waiver of federal Medicaid laws,

including services provided through the BC+ and BC+ Core programs. Certain

parents and caretaker relatives with incomes of not more than 100 percent of the

FPL, before a 5 percent income disregard is applied, are eligible for BC+ benefits.

Adults who are under age 65, who have family incomes that do not exceed 100 percent

of the FPL, before a 5 percent income disregard is applied, and who are not otherwise

eligible for MA, including BC+ (childless adults), are eligible for benefits under BC+

Core.

The federal Patient Protection and Affordable Care Act allows a state to receive

an enhanced federal medical assistance percentage (FMAP) payment for providing

benefits to certain individuals through a state's MA program. The bill expands the

income eligibility level for parents and caretaker relatives under BC+ and for

childless adults under BC+ Core. The bill requires DHS to comply with all federal

requirements and to submit any amendment to the state MA plan, request for a

waiver of Medicaid law, or other federal approval necessary to qualify for the highest

available enhanced FMAP for parents and caretaker relatives and childless adults

eligible for BC+ Core (collectively nonpregnant, nonelderly adults). If DHS does not

qualify for the enhanced FMAP or if the FMAP is reduced, DHS is required to submit

to the Joint Committee on Finance (JCF) a fiscal analysis comparing the cost of

covering nonpregnant, nonelderly adults under the MA program at up to 133 percent

of the FPL to the cost of limiting income eligibility to those adults to up to 100 percent

of the FPL. DHS may reduce income eligibility levels for nonpregnant, nonelderly