SB 245

This bill makes various changes to eligibility determinations for public

assistance programs and, specifically, the BadgerCare Plus program. Currently, the

Department of Health Services administers the Medical Assistance program, 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 the BadgerCare Plus

program. Under current law, certain children, pregnant women, parents and

caretaker relatives, former foster care youth, and adults aged 19 to 64 who are not

receiving Medicare and who do not have dependent children are eligible for benefits

under the BadgerCare Plus program if they meet certain financial criteria.

The bill prohibits DHS from automatically renewing the eligibility of a

recipient under the BadgerCare Plus program. DHS must determine an individual's

eligibility every six months under the bill. DHS is also prohibited from using

prepopulated forms or otherwise supplying information, except for name and

address, to a recipient under the BadgerCare Plus program that has been supplied

to DHS. Additionally, any recipient under the BadgerCare Plus program that fails

to timely report to DHS or its designee any change that may affect eligibility is

ineligible for benefits for six months from the date DHS discovers the failure to report

the change. Under current law, knowingly concealing or failing to disclose any event

that an individual knows affects the initial or continued right to a Medical Assistance

benefit is subject to a forfeiture of not less than $100 nor more than $15,000 for each

concealment or failure.

The bill requires DHS to enter data sharing agreements with any agency that

maintains a database of financial or personal information about residents of this

state. DHS must confirm the information of an applicant for a public assistance

program against the information contained in those databases. The bill also requires

DHS to share data for this purpose of confirming eligibility for public assistance

programs. Current law requires DHS and the Department of Children and Families

to compare each department's respective databases against the databases of death

records to identify deceased participants.

The bill requires DHS to promptly remove from eligibility for the BadgerCare

Plus program any individual who enrolled in the program and who has been

determined to be ineligible for the program. Under the federal Families First

Coronavirus Act, during a federally declared public health emergency, a state may

receive an enhanced amount of federal financial participation in its Medical

Assistance program if the state complies with certain criteria, including refraining

from disenrolling individuals from the program. Under the federal Consolidated

Appropriation Act, 2023, enhanced federal financial participation ends for all states

after December 31, 2023. Under the bill, if the disenrollment or any other part of the

bill would cause the state not to qualify for enhanced federal financial participation