2013 WISCONSIN ACT
226
An Act
to repeal
49.141 (7) (b), 49.141 (9) (title), 49.141 (10) (title) and (b), 49.49 (1) (title) and (a) (intro.), 49.49 (1) (b), 49.49 (2) (title) and (2) (a) (title), 49.49 (2) (b) (title), 49.49 (2) (c) (title), 49.49 (3) (title), 49.49 (3m) (title), 49.49 (3m) (b), 49.49 (4) (title), 49.795 (1) (cm), 49.795 (7), 49.795 (8) (a), (b) and (c) and 49.95;
to renumber
49.495 (title) and 49.795 (title) and (1) (intro.);
to renumber and amend
49.141 (7) (a), 49.141 (9) (a) to (c), 49.141 (10) (a), 49.49 (1) (a) 1. to 4., 49.49 (1) (c), 49.49 (2) (a), 49.49 (2) (b), 49.49 (2) (c), 49.49 (3), 49.49 (3m) (a), 49.495, 49.795 (1) (a), (b), (c), (d) and (e), 49.795 (2) to (6), 49.795 (8) (d) 1., 49.795 (8) (d) 1m., 49.795 (8) (d) 2. and 49.795 (8) (e) and (f);
to consolidate, renumber and amend
49.49 (4) (a) and (b);
to amend
49.141 (7) (c) (intro.) and 1., 49.141 (8), 49.32 (8), 49.45 (2) (b) 7. (intro.) and a., and (11), 49.49 (3p) (title), 49.49 (5), 49.49 (7) (d), 49.688 (9) (a), 49.797 (2) (a), 59.54 (23) and 940.11 (2);
to repeal and recreate
49.141 (7) (title); and
to create
49.835, 49.846 (1), 946.90 (title), 946.90 (1), 946.90 (2), 946.91 (title), (1) and (2) (intro.), 946.92 (3) (a) and 946.93 of the statutes;
relating to:
applications for public assistance programs, offenses in public assistance programs, granting rule-making authority, and providing a penalty.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
Section
1
.
49.141 (7) (title) of the statutes is repealed and recreated to read:
49.141
(7)
(title)
Suspensions.
Section
2
.
49.141 (7) (a) of the statutes is renumbered 946.90 (3) and amended to read:
946.90
(3)
A person who is convicted of violating sub. (6) in connection with the
Whoever violates sub. (2) by
furnishing
by that person of
items or services for which payment is or may be made under Wisconsin
works
Works
is guilty of a Class H felony.
Section
3
.
49.141 (7) (b) of the statutes is repealed.
Section
4
.
49.141 (7) (c) (intro.) and 1. of the statutes are amended to read:
49.141
(7)
(c) (intro.) Except as provided in par. (d), in addition to the penalties applicable under
par. (a) or (b)
s. 946.90 (2) or (3)
, a person shall be suspended from participating in Wisconsin
works
Works
for a period of 10 years, beginning on the date of conviction, if the person is convicted in a federal or state court for any of the following:
1. Violating sub. (6) (a)
or s. 946.90 (2) (a)
with respect to his or her identity or place of residence for the purpose of receiving simultaneously from this state and at least one other state assistance funded by a block grant under Title I of the Federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
Section
5
.
49.141 (8) of the statutes is amended to read:
49.141
(8)
Damages.
If a person is convicted under
sub. (6)
s. 946.90 (2) or (3)
, the state has a cause of action for relief against the person in an amount equal to 3 times the amount of actual damages sustained as a result of any excess payments made in connection with the offense for which the conviction was obtained. Proof by the state of a conviction under
sub. (6)
s. 946.90 (2) or (3)
is conclusive proof in a civil action of the state's right to damages and the only issue in controversy shall be the amount, if any, of the actual damages sustained. Actual damages consist of the total amount of excess payments, any part of which is paid with state funds. In a civil action under this subsection, the state may elect to file a motion in expedition of the action. Upon receipt of the motion, the presiding judge shall expedite the action.
Section
6
.
49.141 (9) (title) of the statutes is repealed.
Section
7
.
49.141 (9) (a) to (c) of the statutes are renumbered 946.90 (4) (a) to (c), and 946.90 (4) (a), (b) and (c) 1., as renumbered, are amended to read:
946.90
(4)
(a) Whoever solicits or receives
any remuneration in cash or in-kind
money, goods, services, or any other thing of value
, in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under Wisconsin
works
Works
, or in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under Wisconsin
works
Works
, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
(b) Whoever offers or
pays any remuneration in cash or in-kind
provides money, goods, services, or any other thing of value
to any person to induce the person to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under Wisconsin
works
Works
, or to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service or item for which payment may be made in whole or in part under any provision of Wisconsin
works
Works
, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
(c) 1. A discount or other reduction in price obtained by a provider of services or other entity under chs. 46 to 51 and 58 if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity under Wisconsin
works
Works
.
Section
8
.
49.141 (10) (title) and (b) of the statutes are repealed.
Section
9
.
49.141 (10) (a) of the statutes is renumbered 946.90 (5) and amended to read:
946.90
(5)
A provider
may not
who
knowingly
impose
imposes
upon a
recipient
participant in Wisconsin Works
charges in addition to payments received
by the provider
for services under Wisconsin
works
Works
or knowingly
impose
imposes
direct charges upon a
recipient
participant in Wisconsin Works
in lieu of obtaining payment under Wisconsin
works unless
Works is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000. This subsection does not apply if
benefits or services are not provided under Wisconsin
works
Works
and the
recipient
Wisconsin Works participant
is advised of this fact prior to receiving the service.
Section
10
.
49.32 (8) of the statutes is amended to read:
49.32
(8)
Periodic earnings check by department.
The department shall make a periodic check of the amounts earned by recipients of aid to families with dependent children under s. 49.19 and by participants under Wisconsin works under ss. 49.141 to 49.161 through a check of the amounts credited to the recipient's social security number. The department shall make an investigation into any discrepancy between the amounts credited to a social security number and amounts reported as income on the declaration application and take appropriate action under s.
49.95
946.93
when warranted. The department shall use the state wage reporting system under
1985 Wisconsin Act 17
, section
65 (1)
, when the system is implemented, to make periodic earnings checks.
Section
11
.
49.45 (2) (b) 7. (intro.) and a., and (11) of the statutes are amended to read:
49.45
(2)
(b) 7. (intro.) Require, as a condition of certification under par. (a) 11., all providers of a specific service that is among those enumerated under s. 49.46 (2), 49.47 (6) (a), or 49.471 (11), as specified in this subdivision, to file with the department a surety bond issued by a surety company licensed to do business in this state. Providers subject to this subdivision provide those services specified under s. 49.46 (2), 49.47 (6) (a), or 49.471 (11) for which providers have demonstrated significant potential to violate s. 49.49
(1) (a), (2) (a) or (b), (3), (3m) (a),
(3p)
, (4) (a),
or (4m) (a)
or 946.91 (2), (3) (a) or (b), (4), (5), or (6)
, to require recovery under par. (a) 10., or to need additional sanctions under par. (a) 13. The surety bond shall be payable to the department in an amount that the department determines is reasonable in view of amounts of former recoveries against providers of the specific service and the department's costs to pursue those recoveries. The department shall promulgate rules to implement this subdivision that specify all of the following:
a. Services under
medical assistance
Medical Assistance
for which providers have demonstrated significant potential to violate s. 49.49
(1) (a), (2) (a) or (b), (3), (3m) (a),
(3p)
, (4) (a),
or (4m) (a)
or 946.91 (2), (3) (a) or (b), (4), (5), or (6)
, to require recovery under par. (a) 10., or to need additional sanctions under par. (a) 13.
(11)
Penalty.
Any person who receives or assists another in receiving assistance under this section, to which the recipient is not entitled, shall be subject to the penalties under
s. 49.95
ss. 946.91 and 946.93
.
Section
12
.
49.49 (1) (title) and (a) (intro.) of the statutes are repealed.
Section
13
.
49.49 (1) (a) 1. to 4. of the statutes are renumbered 946.91 (2) (a) to (d) and amended to read:
946.91
(2)
(a)
Knowingly and willfully make
Intentionally makes
or
cause
causes
to be made any false statement or representation of a material fact in any application for any
Medical Assistance
benefit or payment.
(b)
Knowingly and willfully make
Intentionally makes
or
cause
causes
to be made any false statement or representation of a material fact for use in determining
rights to such
eligibility for any Medical Assistance
benefit or payment.
(c) Having knowledge of the occurrence of any event affecting the initial or continued
right to
eligibility for
any
such
Medical Assistance
benefit or payment or the initial or continued
right to
eligibility for
any such benefit or payment of any other individual in whose behalf he or she has applied for or is receiving such benefit or payment,
conceal
conceals
or
fail
fails
to disclose such event with an intent
to
fraudulently
to
secure such benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized.
(d) Having
made application
applied
to receive any
such
Medical Assistance
benefit or payment for the use and benefit of another and having received it, knowingly and willfully
convert such
converts the
benefit or payment or any part thereof to a use
other than for the use and
that is not for the
benefit of such other person.
Section
14
.
49.49 (1) (b) of the statutes is repealed.
Section
15
.
49.49 (1) (c) of the statutes is renumbered 49.49 (1d) and amended to read:
49.49
(1d)
Damages.
If any person is convicted under
this subsection
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 conviction was obtained. Proof by the state of a conviction under
this section
s. 946.91 (2)
in a civil action shall be conclusive regarding the state's right to damages and the only issue in controversy shall be the amount, if any, of the actual damages sustained. Actual damages shall consist of the total amount of excess payments, any part of which is paid by state funds. In any such civil action the state may elect to file a motion in expedition of the action. Upon receipt of the motion, the presiding judge shall expedite the action.
Section
16
.
49.49 (2) (title) and (2) (a) (title) of the statutes are repealed.
Section
17
.
49.49 (2) (a) of the statutes is renumbered 946.91 (3) (a) and amended to read:
946.91
(3)
(a)
Any person who
Whoever
solicits or receives
any remuneration, including any kickback, bribe, or rebate
, directly
or
,
indirectly, overtly
,
or covertly,
in cash or in kind,
money, goods, services, or any other thing of value
in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under
a medical assistance program
Medical Assistance
, or in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under
a medical assistance program
Medical Assistance
, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
Section
18
.
49.49 (2) (b) (title) of the statutes is repealed.
Section
19
.
49.49 (2) (b) of the statutes is renumbered 946.91 (3) (b) and amended to read:
946.91
(3)
(b) Whoever offers or pays
any remuneration including any kickback, bribe, or rebate
provides,
directly
or
,
indirectly, overtly
,
or covertly,
in cash or in kind
money, goods, services, or any other thing of value
to any person to induce such person to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under
a medical assistance program
Medical Assistance
, or to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service or item for which payment may be made in whole or in part under
a medical assistance program
Medical Assistance
, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
Section
20
.
49.49 (2) (c) (title) of the statutes is repealed.
Section
21
.
49.49 (2) (c) of the statutes is renumbered 946.91 (3) (c) and amended to read:
946.91
(3)
(c) This subsection
shall
does
not apply to
any of the following
:
1. A discount or other reduction in price obtained by a provider of services or other entity under chs. 46 to 51 and 58 if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity under
a medical assistance program
Medical Assistance
.
2.
Any
An
amount paid by an employer to an employee who has a bona fide employment relationship with such employer for employment in the provision of covered items or services.
Section
22
.
49.49 (3) (title) of the statutes is repealed.
Section
23
.
49.49 (3) of the statutes is renumbered 946.91 (4) and amended to read:
946.91
(4)
No person may
Whoever
knowingly and willfully
make
makes
or
cause
causes
to be made, or
induce
induces
or
seek
seeks
to induce the making of, any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that such institution or facility may qualify either upon initial certification or upon recertification as a hospital, skilled nursing facility, intermediate care facility, or home health agency
. A person who violates this subsection
is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
Section
24
.
49.49 (3m) (title) of the statutes is repealed.
Section
25
.
49.49 (3m) (a) of the statutes is renumbered 946.91 (5), and 946.91 (5) (intro.), (a), (b) and (c), as renumbered, are amended to read:
946.91
(5)
(intro.)
No provider may
Whoever
knowingly
impose
imposes
upon a
Medical Assistance
recipient charges in addition to payments received for services under ss. 49.45 to 49.471 or knowingly
impose
imposes
direct charges upon a recipient in lieu of obtaining payment under ss. 49.45 to 49.471
except under the following conditions
is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000. This subsection does not apply under any of the following circumstances
:
(a) Benefits or services are not provided under s. 49.46 (2) or 49.471 (11) and the
Medical Assistance
recipient is advised of this fact prior to receiving the service.
(b)
If an
An
applicant is determined to be eligible retroactively under s. 49.46 (1) (b), 49.47 (4) (d), or 49.471
and
,
a provider bills the applicant directly for services and benefits rendered during the retroactive period, the provider
shall
, upon notification of the applicant's retroactive eligibility,
submit claims
submits a claim
for payment under s. 49.45 for covered services or benefits rendered to the recipient during the retroactive period
. Upon receipt of payment under s. 49.45, the provider shall reimburse
, and the provider reimburses
the recipient or other person who has made prior payment to the provider for services provided to the recipient during the retroactive eligibility period, by the amount of the prior payment made
upon receipt of payment under s. 49.45
.
(c) Benefits or services
are provided
for which recipient copayment, coinsurance, or deductible is required under s. 49.45 (18), not to exceed maximum amounts allowable under
42 CFR 447.53
to
447.58
, or for which recipient copayment or coinsurance is required under s. 49.471 (11).
Section
26
.
49.49 (3m) (b) of the statutes is repealed.
Section
27
.
49.49 (3p) (title) of the statutes is amended to read:
49.49
(3p)
(title)
Other
prohibited provider charges.
Section
28
.
49.49 (4) (title) of the statutes is repealed.
Section
29
.
49.49 (4) (a) and (b) of the statutes are consolidated, renumbered 946.91 (6) and amended to read:
946.91
(6)
No person
Whoever
, in connection with
the medical assistance
program
Medical Assistance
when the cost of the services provided to the patient is paid for in whole or in part by the state,
may knowingly and willfully charge, solicit, accept or receive
intentionally charges, solicits, accepts, or receives
, in addition to any amount otherwise required to be paid under
a medical assistance program
Medical Assistance
, any gift, money, donation
,
or other consideration, other than a charitable, religious
,
or philanthropic contribution from an organization or from a person unrelated to the patient, as a precondition of admitting a patient to a hospital, skilled nursing facility
,
or intermediate care facility, or as a requirement for the patient's continued stay in such a facility
. (b) A person who violates this subsection
is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
Section
30
.
49.49 (5) of the statutes is amended to read:
49.49
(5)
County collection.
Any county may retain
15%
15 percent
of state
medical assistance
Medical Assistance
funds that are recovered due to the efforts of a county employee or officer or, if the county initiates action by the department of justice, due to the efforts of the department of justice under s.
49.495
49.846
. This subsection applies only to recovery of medical assistance that was provided as a result of fraudulent activity by a recipient or by a provider.
Section
31
.
49.49 (7) (d) of the statutes is amended to read:
49.49
(7)
(d) A commission's imposition of an assessment described under par. (b), a member's payment of the assessment as described under par. (c), and acceptance of the payment by the commission do not constitute conduct prohibited under
sub. (4)
s. 946.91 (6)
or prohibited under s. DHS 106.04 (3), Wis. Adm. Code, in effect on May 26, 2010. It is the intent of the legislature to create a mechanism whereby 2 or more political subdivisions may share in the operation, use, and funding of a nursing home or intermediate care facility without violating
42 USC 1320a-7b
(d) or
42 USC 1396a
(a) (25) (C).
Section
32
.
49.495 (title) of the statutes is renumbered 49.846 (title).
Section
33
.
49.495 of the statutes is renumbered 49.846 (2) and amended to read:
49.846
(2)
The department of justice or the district attorney may institute, manage, control
,
and direct, in the proper county, any prosecution for violation of criminal laws affecting
the medical
a public
assistance program
,
including
but not limited to
laws
in this chapter, chs. 939 to 951
relating to
medical assistance contained in this subchapter
Medical Assistance, Wisconsin Works, the food stamp program, or any other public assistance program,
and laws affecting the health, safety
,
and welfare of
public assistance program
recipients
of medical assistance
. For this purpose the department of justice shall have and exercise all powers conferred upon district attorneys in such cases.
The
If a prosecution under this section involves a person holding a license granted by the medical examining board or an interested affiliated credentialing board, the
department of justice or district attorney shall notify the medical examining board or the interested affiliated credentialing board of
any such
the
prosecution
of a person holding a license granted by the board or affiliated credentialing board
.
Section
34
.
49.688 (9) (a) of the statutes is amended to read:
49.688
(9)
(a) The department shall promulgate rules relating to prohibitions on fraud that are substantially similar to applicable provisions under s.
49.49 (1) (a)
946.91 (2)
.
Section
35
.
49.795 (title) and (1) (intro.) of the statutes are renumbered 946.92 (title) and (1) (intro.).
Section
36
.
49.795 (1) (a), (b), (c), (d) and (e) of the statutes are renumbered 946.92 (1) (a), (b), (c), (d) and (e), and 946.92 (1) (b), (c) and (d), as renumbered, are amended to read:
946.92
(1)
(b) "Food" means items
which
that
may be purchased using food
coupons
stamp program benefits
under 7 USC
2012 (g) and
2016 (b).
(c) "Food stamp program" means the federal food stamp program under
7 USC 2011
to
2029
2036a
.
(d) "Supplier" means a retail grocery store or other person authorized by the federal department of agriculture to accept food
coupons
stamp program benefits
in exchange for food under the food stamp program.
Section
37
.
49.795 (1) (cm) of the statutes is repealed.
Section
38
.
49.795 (2) to (6) of the statutes are renumbered 946.92 (2) (a) to (f), and 946.92 (2) (c), (d), (e) and (f), as renumbered, are amended to read:
946.92
(2)
(c) No person may knowingly issue food
coupons
stamp program benefits
to a person who is not an eligible person or knowingly issue food
coupons
stamp program benefits
to an eligible person in excess of the amount for which the person's household is eligible.
(d) No eligible person may knowingly transfer food
coupons
stamp program benefits
except to purchase food from a supplier or knowingly obtain or use food
coupons
stamp program benefits
for which the person's household is not eligible.
(e) No supplier may knowingly obtain food
coupons
stamp program benefits
except as payment for food or knowingly obtain food
coupons
stamp program benefits
from a person who is not an eligible person.
(f) No unauthorized person may knowingly obtain, possess, transfer
,
or use food
coupons
stamp program benefits
.
Section
39
.
49.795 (7) of the statutes is repealed.
Section
40
.
49.795 (8) (a), (b) and (c) of the statutes are repealed.
Section
41
.
49.795 (8) (d) 1. of the statutes is renumbered 946.92 (3) (b) and amended to read:
946.92
(3)
(b) In addition to the penalties applicable under par. (a),
(b) or (c),
the court shall suspend a person who violates
this section
sub. (2)
from participation in the food stamp program as follows:
1. For a first
offense
conviction
under this section,
for not less than
one year
. The court may extend the suspension by
and
not more than
18 months
2 years and 6 months
.
2. For a 2nd
offense
conviction
under this section,
for not less than
2 years
. The court may extend the suspension by
and
not more than
18 months
3 years and 6 months
.
3. For a 3rd
offense
conviction
under this section, permanently.
Section
42
.
49.795 (8) (d) 1m. of the statutes is renumbered 946.92 (3) (c) and amended to read:
946.92
(3)
(c) In addition to the penalties applicable under par. (a),
(b) or (c),
a court shall permanently suspend from the food stamp program a person who has been convicted of an offense under
7 USC 2024
(b) or (c) involving an item covered by
7 USC 2024
(b) or (c) having a value of $500 or more.
Section
43
.
49.795 (8) (d) 2. of the statutes is renumbered 49.796 and amended to read:
49.796
Food stamp reinstatement.
The
A
person may apply to
the
a
multicounty consortium
, as defined in s. 49.78 (1) (br),
or
the
a
federally recognized American Indian tribal governing body or, if the person is a supplier,
as defined in s. 946.92 (1) (d),
to the federal department of agriculture for reinstatement
of benefits
following
the
a
period of suspension
imposed under s. 946.92
, if the suspension is not permanent.
Section
44
.
49.795 (8) (e) and (f) of the statutes are renumbered 946.92 (3) (d) and (e) and amended to read:
946.92
(3)
(d) 1. If
a court finds that
a person
traded
violated sub. (2) by trading
a controlled substance, as defined in s. 961.01 (4), for food
coupons
stamp program benefits
, the court shall suspend the person from participation in the food stamp program as follows:
a. Upon
the first such finding
a first conviction
, for 2 years.
b. Upon
the
a
2nd
such finding
conviction
, permanently.
2. If
a court finds that
a person
traded
violated sub. (2) by trading
firearms, ammunition
,
or explosives for food
coupons
stamp program benefits
, the court shall suspend the person permanently from participation in the food stamp program.
(e) Notwithstanding
par. (d)
pars. (b) and (c)
, in addition to the penalties applicable under par. (a)
, (b) or (c)
, the court shall suspend from the food stamp program for a period of 10 years a person who
violates sub. (2) by
fraudulently
misstates
misstating
or
misrepresents
misrepresenting
his or her identity or place of residence for the purpose of receiving multiple benefits simultaneously under the food stamp program.
Section
45
.
49.797 (2) (a) of the statutes is amended to read:
49.797
(2)
(a) Notwithstanding s. 46.028 and except as provided in par. (b) and sub. (8), the department shall administer a statewide program to deliver food stamp benefits to recipients of food stamp benefits by an electronic benefit transfer system. All suppliers, as defined in s.
49.795
946.92
(1) (d), may participate in the delivery of food stamp benefits under the electronic benefit transfer system. The department shall explore methods by which nontraditional retailers, such as farmers' markets, may participate in the delivery of food stamp benefits under the electronic benefit transfer system.
Section
46
.
49.835 of the statutes is created to read:
49.835
Statements in applications.
A person who makes a statement in a written application for any aid or benefit provided under this chapter is considered to have made an admission as to the existence, correctness, or validity of any fact stated. Such a statement is prima facie evidence against the person who made it in any complaint, information, or indictment, or in any action brought for enforcement of any provision of this chapter.
Section
47
.
49.846 (1) of the statutes is created to read:
49.846
(1)
In this section, "public assistance program" means any program administered by the department of health services or the department of children and families under this chapter under which the department administering the program provides services, benefits, or other assistance to individuals or families.
Section
48
.
49.95 of the statutes is repealed.
Section
49
.
59.54 (23) of the statutes is amended to read:
59.54
(23)
Public assistance; false representation.
The board may enact and enforce an ordinance to prohibit conduct that is the same as or similar to conduct that is prohibited by s.
49.95 (1)
946.93 (2)
and provide a forfeiture for a violation of the ordinance.
Section
50
.
940.11 (2) of the statutes is amended to read:
940.11
(2)
Whoever hides or buries a corpse, with intent to conceal a crime or avoid apprehension, prosecution
,
or conviction for a crime or notwithstanding s.
49.141 (7), 49.49 (1), or 49.795
946.90 (2) or (3), 946.91 (2), 946.92, or 946.93 (2) or (3)
with intent to collect benefits under
one of those sections
the assistance program for families with dependent children administered under ss. 49.141 to 49.161, the Medical Assistance program administered under subch. IV of ch. 49, or the food stamp program, as defined in s. 49.79 (1) (c)
, is guilty of a Class G felony.
Section
51
.
946.90 (title) of the statutes is created to read:
946.90
(title)
Wisconsin Works fraud.
Section
52
.
946.90 (1) of the statutes is created to read:
946.90
(1)
In this section:
(a) "Provider" means a Wisconsin Works agency, a person that contracts with a Wisconsin Works agency to provide services to a participant in Wisconsin Works, or a person that provides child care for reimbursement under s. 49.155.
(b) "Wisconsin Works" means the assistance program for families with dependent children administered under ss. 49.141 to 49.161.
(c) "Wisconsin Works agency" has the meaning given in s. 49.001 (9).
Section
53
.
946.90 (2) of the statutes is created to read:
946.90
(2)
Whoever does any of the following is guilty of a Class A misdemeanor:
(a) Intentionally makes or causes to be made any false statement or representation of a material fact in any application for or receipt of any Wisconsin Works benefit or payment.
(b) Having knowledge of the occurrence of any event affecting the initial or continued eligibility for a Wisconsin Works benefit or payment under Wisconsin Works, conceals or fails to disclose that event with an intent to fraudulently secure a Wisconsin Works benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized.
Section
54
.
946.91 (title), (1) and (2) (intro.) of the statutes are created to read:
946.91
(title)
Medical Assistance fraud.
(1)
In this section:
(a) "Facility" means a nursing home or a community-based residential facility that is licensed under s. 50.03 and that is certified by the department of health services as a provider of aid under Medical Assistance.
(b) "Medical Assistance" means the program providing aid under subch. IV of ch. 49, except ss. 49.468 and 49.471.
(c) "Provider" means a person, corporation, limited liability company, partnership, incorporated business, or professional association, and any agent or employee thereof, who provides services under Medical Assistance.
(2)
(intro.) Whoever does any of the following is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000:
Section
55
.
946.92 (3) (a) of the statutes is created to read:
946.92
(3)
(a) Whoever violates sub. (2) is subject to the following penalties:
1. If the value of the food stamp program benefits does not exceed $100, a Class B misdemeanor.
2. Except as provided in subd. 3., if the value of the food stamp program benefits exceeds $100, but is less than $5,000, a Class I felony.
3. If the value of the food stamp program benefits exceeds $100, but is less than $5,000, and the person has a prior conviction under this section, a Class H felony.
4. If the value of the food stamp program benefits is $5,000 or more, a Class G felony.
Section
56
.
946.93 of the statutes is created to read:
946.93
Public assistance fraud.
(1)
In this section, "public assistance" means any aid, benefit, or services provided under ch. 49.
(2)
Whoever intentionally makes or causes to be made any false statement or representation of material fact in any application for or receipt of public assistance is guilty of a Class A misdemeanor.
(3)
No person may do any of the following:
(a) Having knowledge of an event affecting the initial or continued eligibility for public assistance, conceal or fail to disclose that event with an intent to fraudulently secure public assistance, including payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized.
(b) Receive any income or assets and fail to notify the public assistance agency within 10 days after receiving the income or assets, unless a different time period is required under the applicable public assistance program.
(c) Fail to notify the public assistance agency within 10 days of any change in circumstances for which notification by the recipient must be provided under law, unless a different time period is required under the applicable public assistance program.
(d) Receive a voucher under a public assistance program for goods or services and use the funding granted under the voucher for purposes that are not authorized by the public assistance agency.
(e) Whoever violates par. (a), (b), (c), or (d) is subject to the following penalties:
1. If the value of the payment or benefit does not exceed $300, a Class B forfeiture.
2. If the value of the payment or benefit is more than $300 but does not exceed $1,000, a Class B misdemeanor.
3. If the value of the payment or benefit is more than $1,000 but does not exceed $2,000, a Class A misdemeanor.
4. If the value of the payment or benefit is more than $2,000 but does not exceed $5,000, a Class I felony.
5. If the value of the payment or benefit is more than $5,000 but does not exceed $10,000, a Class H felony.
6. If the value of the payment or benefit is more than $10,000, a Class G felony.
(4)
A person who obtains money, goods, services, or any other thing of value because he or she sends or brings a person to a county department, federally recognized American Indian tribe or band, multicounty consortium, or Wisconsin Works agency for the purpose of obtaining public assistance is guilty of a Class C misdemeanor.
(5)
(a) Whoever solicits or receives money, goods, services, or any other thing of value in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which a public assistance payment may be made in whole or in part, or in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which public assistance payment may be made in whole or in part, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
(b) Whoever offers or provides money, goods, services, or any other thing of value to any person to induce the person to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which public assistance payment may be made in whole or in part, or to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which public assistance payment may be made in whole or in part, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.
(c) This subsection does not apply to any of the following:
1. A discount or other reduction in price obtained by a provider of services or other entity under chs. 46 to 51 and 58 if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity under a public assistance program.
2. An amount paid by an employer to an employee who has a bona fide employment relationship with the employer for employment in the provision of covered items or services.
(6)
Whoever makes any statement in a written application for public assistance is considered to have made an admission as to the existence, correctness, or validity of any fact stated. Such a statement is prima facie evidence against the person who made it in any complaint, information, or indictment, or in any action brought for enforcement of any provision of this section or ch. 49.
Section
58
.
Initial applicability.
(1)
Public assistance applications.
The treatment of section 49.835 of the statutes first applies to applications for aid or benefits under chapter 49 of the statutes that are received by the department of health services or the department of children and families on the effective date of this subsection.
(2)
Public assistance fraud.
The treatment of section 946.93 of the statutes first applies to acts and omissions that occur on the effective date of this subsection.
