reglab/statecodes huggingface dataset:
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 148 - Drug Repository Program › Section DHS 148.06 - Donations of drugs and supplies

Current through June 24, 2024
(1) PERSONS
				ELIGIBLE TO DONATE DRUGS OR SUPPLIES. Any one of the following persons may
				donate legally obtained drugs or supplies to a drug repository, if the drugs or
				supplies meet the requirements under sub. (2), as determined by a pharmacist
				who is employed by or under contract with a drug repository:
(a) An individual who is 18 years old or
				older.
(b) A pharmacy, medical
				facility, manufacturer, or distributor, if the donated drugs have not been
				previously dispensed or administered.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 148 - Drug Repository Program › Section DHS 148.07 - Dispensing requirements

Current through June 24, 2024
(1) Drugs and
				supplies shall be dispensed by a licensed pharmacist consistent with the
				requirements in s.
				450.11,
				Stats., and ch. Phar 7 or a practitioner consistent with the requirements in
				ch. Med 17.
(2) The pharmacist
				shall inspect drugs and supplies for adulteration, misbranding, and the date of
				expiration before dispensing. Drugs or supplies that are expired, adulterated,
				or misbranded may not be dispensed.
(3) Before a drug or supply may be dispensed
				to a recipient, the recipient shall sign a drug repository recipient form and
				shall be orally notified that the drug or supply may have been previously
				dispensed.
(4) Drugs and supplies
				shall be dispensed only to recipients who meet the eligibility requirements in
				s.
				DHS
				148.05, in the following order of priority:
(a) Individuals who are uninsured.
(b) Individuals who receive or are eligible
				to receive Medicaid, Medicare, or other government based health care.
(c) All other individuals who are otherwise
				eligible under s.
				DHS
				148.05 to receive drugs or supplies from a drug
				repository.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 148 - Drug Repository Program › Section DHS 148.08 - Handling fees

Current through June 24, 2024
A drug repository may charge the recipient of a drug or
				  supply a handling fee of no more than 300% of the Medicaid dispensing fee for
				  each drug or supply dispensed.
The Medicaid dispensing fee can be found in the Wisconsin
					 Medicaid Pharmacy Handbook, which can be obtained from the Department's website
					 at
https://www.forwardhealth.wi.gov/WIPortal/Online%20Handbooks/Display/tabid/152/Default.aspx
.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 148 - Drug Repository Program › Section DHS 148.09 - Distribution of donated drugs and supplies

Current through June 24, 2024
(1) Drug
				repositories may distribute drugs and supplies donated under the drug
				repository program to other repositories if requested by a participating
				repository.
(2) A drug repository
				that has elected not to dispense donated drugs or supplies shall distribute
				those drugs and supplies to a participating repository upon request of the
				repository.
(3) If a drug
				repository distributes drugs or supplies under sub. (1) or (2), the repository
				shall complete a drug repository donor form. The completed form and a copy of
				the donor form that was completed by the original donor under s.
				DHS 148.06(2) (a)
				1 shall be provided to the fully
				participating drug repository at the time of distribution.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 148 - Drug Repository Program › Section DHS 148.11 - Recordkeeping requirements

Current through June 24, 2024
(1) DONOR AND
				RECIPIENT FORMS. Drug repository donor and recipient forms shall be maintained
				for at least 5 years.
(2)
				DESTRUCTION OF DONATED DRUGS OR SUPPLIES. A record of destruction of donated
				drugs and supplies that are not dispensed under s.
				DHS
				148.07 shall be maintained by the dispensing
				repository for at least 5 years. For each drug or supply destroyed, the record
				shall include all of the following information:
(a) The date of destruction.
(b) The name, strength and quantity of the
				drug destroyed.
(c) The name of the
				person or firm that destroyed the drug.
(d) The source of the drugs or supplies
				destroyed.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter I - General Provisions › Section DHS 149.01 - Authority and purpose

Current through June 24, 2024
This chapter is adopted pursuant to ss.
					 46.016,
					 227.11(2)
					 (a) and 253.06(5) (a), Stats., and a state
					 plan under s.
					 253.03,
					 Stats., and 7 CFR 246. This chapter establishes the criteria for approval of
					 grocery stores and pharmacies as authorized vendors to sell foods to
					 participants under the special supplemental nutrition program for women,
					 infants and children (WIC). This chapter also establishes criteria for
					 individuals who receive or apply to receive benefits under the WIC program. The
					 WIC program was established under section 17 of the Child Nutrition Act of
					 1966, as amended,
					 42
					 USC 1786 and 7 CFR 246.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter I - General Provisions › Section DHS 149.02 - Applicability

Current through June 24, 2024
This chapter applies to applicants for WIC vendor
					 authorization, authorized vendors, WIC participants, applicants for WIC program
					 benefits, and persons serving as proxies for participants.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter II - Vendor Authorization And Responsibilities › Section DHS 149.04 - Food distribution centers

Current through June 24, 2024
Food distribution centers shall comply with this chapter
					 and s.
					 253.06,
					 Stats.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter II - Vendor Authorization And Responsibilities › Section DHS 149.06 - Application requirements

Current through June 24, 2024
(1) Only persons
				  who meet the eligibility requirements under s.
				  DHS
				  149.05 may apply for authorization. An eligible person
				  who wishes to apply for authorization shall apply to the state WIC office on an
				  application form obtained from the state WIC office. The person applying for
				  initial authorization shall complete each application form fully and
				  accurately; submit for each application a stock price survey indicating the
				  non-sale prices of approved food available on the day the application is
				  submitted to the state WIC office; participate in training as requested under
				  sub. (2); and provide additional information requested from the state WIC
				  office or the state WIC office designee. An application for authorization shall
				  be submitted under each of the following circumstances:
(a)
Multiple locations.
If a
				  person wishes to accept and redeem WIC checks at multiple locations, a separate
				  application shall be completed and submitted for each grocery store or pharmacy
				  for which the person wishes to accept and redeem WIC checks.
(b)
Change of ownership.
If
				  a person takes ownership, whether by gift, purchase, or lease of an authorized
				  vendor, the person taking ownership shall submit an application at least 15
				  days before change of ownership.
(c)
Change of vendor
				  location.
With the exception of s.
				  DHS
				  149.08(6), if the location of an
				  authorized vendor is changed, the person responsible for the change shall
				  complete an application for authorization for the new location. The vendor may
				  not accept or redeem WIC checks at the new location until the vendor has
				  received authorization from the state WIC office for the new location.
Note: See s.
					 DHS
					 149.08(6) for procedures for
					 reporting a change of location.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter II - Vendor Authorization And Responsibilities › Section DHS 149.08 - Vendor responsibilities

Current through June 24, 2024
(1) COMPLIANCE WITH
				  FEDERAL, STATE AND LOCAL REQUIREMENTS. An authorized vendor shall comply with
				  all of the following:
(a) The WIC program
				  requirements specified in this chapter, s.
				  253.06,
				  Stats., and 7 CFR 246.
(b)
				  Applicable federal, state and local health protection laws or
				  ordinances.
(c) The current WIC
				  vendor agreement.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.09 - Monitoring of vendors

Current through June 24, 2024
(1) The state WIC office or the state WIC
				  office designee may monitor a vendor at any time during a contract period
				  including compliance buys, inventory audits, or routine on-site
				  inspections.
(2) When, during the
				  course of a single monitoring, the state WIC office determines an authorized
				  vendor has committed multiple violations, the state WIC office shall impose the
				  sanction corresponding to the most serious violation under s.
				  DHS
				  149.10 or 149.11.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.10 - Mandatory vendor disqualification

Current through June 24, 2024
(1) MANDATORY
				  PERMANENT DISQUALIFICATION.
(a)
1. The state WIC office shall permanently
				  disqualify a vendor from participation in the WIC program if the vendor is
				  convicted of providing cash in exchange for a WIC check or of selling a
				  firearm, ammunition, explosive or controlled substance in exchange for a WIC
				  check. Disqualification of a vendor shall be effective upon the postmark date
				  of the notice of administrative action by the state WIC office to the vendor's
				  address of record.
2. A civil money
				  penalty may not be imposed in lieu of a disqualification under this
				  subsection.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.11 - Discretionary vendor sanctions

Current through June 24, 2024
(1) UP TO ONE YEAR
				  DISQUALIFICATION. The state WIC office may send a warning letter to the vendor,
				  require training for designated vendor personnel, require implementation of a
				  corrective action plan, require payment of a forfeiture, require recoupment,
				  disqualify the vendor for no more than one year, or impose any combination of
				  sanctions for any one of the following violations:
(a) Providing cash for returned authorized
				  food.
(b) Failing to implement a
				  corrective action plan imposed by the state WIC office.
(c) Failing to meet the minimum requirements
				  for authorization listed in s.
				  DHS
				  149.05(3) to (15).
(d) Providing false information to the state
				  WIC office.
(e) One or 2 incidents
				  of violations stated in s.
				  DHS 149.10(3)
				  and (4).
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.12 - Civil money penalty in lieu of disqualification

Current through June 24, 2024
(1) Under s.
				  DHS 149.10(2) to
				  (4), if the state WIC office determines that
				  disqualification of the authorized vendor would result in inadequate
				  participant access, the state WIC office shall impose a civil money penalty in
				  lieu of disqualification. A civil money penalty may not be imposed in lieu of a
				  disqualification under s.
				  DHS
				  149.10(1).
(2) The state WIC office shall use the
				  formula under
				  7 CFR
				  246.12 to calculate a civil money penalty
				  imposed in lieu of disqualification for violations in s.
				  DHS 149.10(2) to
				  (4). The civil money penalty may not exceed
				  $10,000 for each violation. When during the course of a single investigation
				  the state WIC office determines a vendor has committed multiple violations, the
				  state WIC office shall impose a civil money penalty for each of the violations,
				  not to exceed $40,000 for a single investigation.
(3) If a vendor does not pay, only partially
				  pays, or fails to timely pay a civil money penalty, the state WIC office shall
				  disqualify the vendor for the length of the disqualification corresponding to
				  the most serious violation for which the civil money penalty was
				  assessed.
(4) The state WIC office
				  may use installment plans for the collection of civil money
				  penalties.
(5) The state WIC office
				  may double civil money penalties up to the limits allowed under sub.
				  (2).
(6) The state WIC office may
				  not impose a civil money penalty in lieu of disqualification for third or
				  subsequent violations that mandate disqualification.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.13 - Recoupment

Current through June 24, 2024
The state WIC office may recoup excess payments made to the
					 vendor, as verified by the state WIC office, resulting from the vendor's
					 violation of s.
					 DHS
					 149.10. If a recoupment is imposed, the state WIC
					 office shall also impose an enforcement assessment of 50 percent of the amount
					 of the recoupment imposed.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.14 - Reciprocal food stamp program actions

Current through June 24, 2024
(1) The state WIC
				  office shall disqualify from the WIC program a vendor who is disqualified from
				  the food stamp program.
(2) The
				  state WIC office shall impose a civil money penalty in lieu of a
				  disqualification for a food stamp disqualification if the state WIC office
				  determines that WIC disqualification would result in inadequate participant
				  access.
(3) The state WIC office
				  may disqualify a vendor who has had a civil money penalty imposed by the food
				  stamp program in lieu of disqualification.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.15 - Written notice

Current through June 24, 2024
The state WIC office shall begin an adverse action,
					 including disqualification, denial, or imposition of a civil money penalty,
					 forfeiture, recoupment or enforcement assessment by serving upon the vendor a
					 written notice of the action which shall include applicable appeal rights. With
					 the exception of actions under s.
					 DHS
					 149.10(1), the service shall be made
					 by certified mail or personal delivery at least 15 days in advance of the
					 effective date of the action described in the notice.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.16 - Voluntary withdrawal or non-renewal of agreement

Current through June 24, 2024
Except as provided in the discretionary sanctions listed in
					 s.
					 DHS
					 149.11, the state WIC office may not accept an
					 authorized vendor's voluntary withdrawal from the WIC program, or use
					 non-renewal of the vendor contract as an alternative to
					 disqualification.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.17 - Summary suspension

Current through June 24, 2024
If the department finds that public health, safety or
					 welfare imperatively requires emergency action and incorporates a finding to
					 that effect in its order, summary suspension of WIC authorization may be
					 ordered pending proceedings for revocation or other action. Such proceedings
					 shall be promptly instituted and determined.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter III - Monitoring, Vendor Violations and Sanctions › Section DHS 149.18 - Vendor and food distribution centers appeals

Current through June 24, 2024
(1)
(a) A vendor or food distribution center may
				  appeal an adverse action by requesting a hearing or an abbreviated review.
				  Vendor appeals are governed by this section and
				  7 CFR
				  246.18, subch. III of ch. 227 and s.
				  253.06(6),
				  Stats., and ch. HA 1.
(b) Requests
				  appealing an adverse action shall be in writing and shall be filed within 15
				  days after service of notice of the adverse action. A request shall be
				  considered filed on the date of actual receipt by the agency, or the date of
				  the postmark, whichever is earlier. A request filed by facsimile is complete
				  upon transmission. If the request is filed by facsimile transmission and such
				  transmission is complete between 5 p.m. and midnight, one day shall be added to
				  the prescribed period.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.19 - Conditions of eligibility

Current through June 24, 2024
In order to be certified or remain certified as a
					 participant to receive WIC benefits, an individual shall meet all of the
					 following requirements:
(1) Is an
				  infant, a child under age 5, pregnant, breastfeeding or a postpartum woman who
				  is within 6 months of delivery.
(2)
				  Lives in Wisconsin.
(3) Has a
				  household gross income that is less than or equal to 185% of the federal
				  poverty level, based on family size. A participant is also income eligible if
				  the participant is currently certified eligible to receive FoodShare, Medicaid,
				  or another similar economic support program.
(4) Has a health or diet need, as determined
				  by WIC staff.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.20 - Notification of participant responsibilities

Current through June 24, 2024
(1) CERTIFICATION
				  APPOINTMENTS. During each certification appointment the local project shall do
				  all of the following:
(a) Inform each
				  applicant, participant, or parent/guardian that it is a violation of state and
				  federal law to participate in more than one local project or local project
				  clinic at the same time. The local project shall provide each applicant,
				  participant or parent/guardian with a written copy of the participant rights
				  and responsibilities and offer the opportunity to have these rights and
				  responsibilities read to them upon request.
(b) Offer each participant, parent/guardian
				  or proxy an explanation of how to use WIC checks, a copy of instructions for
				  using WIC checks, an explanation on how to select authorized WIC food, and a
				  list of authorized vendors.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.21 - Denial or disqualification

Current through June 24, 2024
(1) If the local
				  project determines that an applicant does not meet all of the eligibility
				  requirements for the WIC program, the local project shall notify the applicant
				  or his or her parent/guardian in writing of the ineligibility, the reasons for
				  the ineligibility, and the right to a fair hearing on the determination of
				  ineligibility within 15 days of the determination of ineligibility.
(2) If the local project determines, at any
				  time during the certification period, that a participant is disqualified from
				  program participation, the local project shall notify the participant or
				  parent/guardian in writing at least 15 days before the disqualification. The
				  notice shall specify the reason for the disqualification and advise the
				  participant or parent/guardian of the right to a fair hearing on the
				  determination of the disqualification.
(3) A local project may serve notice of
				  denial or disqualification by certified mail to the participant's address of
				  record or by personal delivery. If service is by certified mail, notice shall
				  be considered filed on the date of mailing.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.22 - Repayments

Current through June 24, 2024
(1) If the local project determines that a
				  participant has received or disposed of WIC benefits fraudulently, the local
				  project shall provide written notice to the participant or parent/guardian of
				  the intent to recover the funds. Such notification shall include an explanation
				  of the reasons for the repayment and of the participant's right to a hearing.
				  The local project shall allow 30 days for the participant to repay the funds or
				  to set up a repayment schedule between the local project and the participant
				  before taking additional collection actions.
(2) A local project may serve determination
				  that repayment is required by certified mail to the participant's address of
				  record or by personal delivery. If service is by certified mail, notice shall
				  be considered filed on the date of mailing.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.23 - Terminating or suspending WIC benefits due to shortage of funds

Current through June 24, 2024
If the state WIC office determines that due to a shortage
					 of funds for the WIC program, a participant's WIC program benefits will be
					 terminated or suspended, the local project shall issue a notice to the
					 participant or parent/guardian at least 15 days before the termination or
					 suspension.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.24 - Mandatory participant or proxy disqualification

Current through June 24, 2024
(1) MANDATORY ONE
				  YEAR DISQUALIFICATION.
(a) Except as provided
				  in par. (b), the local WIC project shall disqualify a participant and the
				  participant's proxy and other family members from the WIC program for one year
				  if the local project determines that the participant or proxy has committed any
				  one of the following violations:
1.
				  Intentionally participating in and spending WIC checks from more than one WIC
				  project or WIC project clinic during the same time period.
2. Intentionally participating in the WIC
				  program and in the commodity supplemental food program at the same
				  time.
3. Committing any violation
				  that results in fraudulent receipt or disposal of $100 or more in WIC
				  benefits.
4. Being assessed by the
				  local project a second or subsequent repayment.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 149 - The special supplemental nutrition program for women, infants and children (WIC) › Subchapter IV - Participants and Proxies › Section DHS 149.25 - Participant appeals

Current through June 24, 2024
(1) ACTIONS APPEALABLE. An applicant or
				  participant may appeal any of the following actions by the local project:
(a) Denial of an application for
				  participation in the WIC program.
(b) Disqualification from the WIC
				  program.
(c) Request for repayment
				  to the WIC program.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 150 › Section DHS 150.03

Current through June 24, 2024
An application for a workplace wellness grant can be
					 completed online at
http://www.dhs.wisconsin.gov/physical-activity/Worksite/index.htm
.
					 A paper application can be obtained from the department by download at
					 http://www.dhs.wisconsin.gov/physical-activity/Worksite/index.htm or by
					 submitting a written request to Chronic Disease Unit, 1 W. Wilson St., Room
					 218, Madison, WI 53703.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 151 - Family planning fund allocations › Section DHS 151.01 - Purpose

Current through June 24, 2024
This chapter establishes the mechanism for the allocation of
				  family planning funds appropriated to the department of health services
				  pursuant to section 927 (18) (kp), ch. 418, laws of 1977.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 151 - Family planning fund allocations › Section DHS 151.02 - Definitions

Current through June 24, 2024
(1) "Family planning" means family planning
				as defined in s.
				253.07(1)
				(a), Stats., and excludes specifically the
				voluntary termination of pregnancy and the provision of sterilization
				procedures to persons who are under the age of 21, incompetent or
				institutionalized.
(2) "Family
				planning services" means family planning services as defined in s.
				253.07(1)
				(b), Stats.
(3) "Coordination of family planning
				services" means the provision of family planning services in a manner that
				ensures the maximum use of existing community health, social service or welfare
				resources and local contractual arrangements.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 151 - Family planning fund allocations › Section DHS 151.03 - Grant procedures

Current through June 24, 2024
(1) Family planning funds shall be allocated
				through a competitive grant award process. The department will establish
				procedures for the submission of grant applications and the awarding of grant
				funds.
(2) All grant applications
				shall, as a minimum, make the following assurances to the department:
(a) That the proposal maximizes the
				coordination of family planning services;
(b) That no persons employed by a grant
				applicant may be required to accept the duty of offering family planning
				services if that duty is contrary to his or her personal beliefs;
(c) That no person will be required by the
				grant applicant to accept family planning services or to state his/her reasons
				for rejecting such services and that such person's right to public assistance,
				public health, or other public service will be unaffected by their
				decision;
(d) That all information
				gathered by the grant applicant as a part of providing family planning
				services, other than statistical information compiled without reference to the
				identity of any individual, shall be released only with the informed consent of
				the individual for whom services have been provided.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 151 - Family planning fund allocations › Section DHS 151.04 - Records and reports

Current through June 24, 2024
Agencies or individuals awarded funds pursuant to this
				  chapter shall submit to the department such reports on number of clients
				  served, services provided and expenditure of funds, as the department may
				  require.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.01 - Authority and purpose

Current through June 24, 2024
This chapter is promulgated under the authority of ss.
				  49.68(2),
				  49.687(1)
				  and
				  227.11(2)
				  (a), Stats., to implement a treatment cost
				  reimbursement program for residents of Wisconsin who have chronic renal
				  disease.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.03 - Eligibility and certification

Current through June 24, 2024
(1) CONDITIONS. To
				be eligible for the CRD program, a patient shall:
(a) Be a resident of Wisconsin;
(b) Be diagnosed as having ESRD;
(c) If eligible for medicare, register and
				pay the premium for coverage by medicare; and
(d) Provide to the department or its
				designated agent full, truthful and correct information necessary for the
				department to determine patient eligibility and liability, including
				information about any change in income of more than 10%. A patient shall be
				denied reimbursement if he or she refuses to provide information, withholds
				information or provides inaccurate information. The department may verify or
				audit a certified patient's total family income. The department may redetermine
				a certified patient's estimated total family income for the current year based
				on change in the family's financial circumstances.
(e) First apply for benefits under all other
				health care coverage programs for which the person may reasonably be eligible,
				including medicare, BadgerCare, medical assistance and SeniorCare.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.035 - Events which affect eligibility

Current through June 24, 2024
(1) Eligibility
				under the CRD program is terminated if any of the following events occur:
(a) The patient dies.
(b) The patient stops making medicare premium
				payments.
(c) The patient moves out
				of the state of Wisconsin.
(d) The
				patient no longer requires a regular course of chronic dialysis because the
				patient's kidneys resume function and the patient has not had a kidney
				transplant.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.04 - Patient rights and responsibilities

Current through June 24, 2024
(1) A certified
				patient or, if the patient is a minor or has a guardian, the patient's parent
				or guardian shall inform the department within 30 days after there is any
				change in the patient's address, other sources of health care coverage, income
				of more than 10% or family size.
(2)
(a) A
				patient applying for benefits or a certified patient may request an
				administrative hearing under subch. III of ch. 227, Stats., in the event that
				reimbursement is denied or certification is terminated.
(b) A request for a hearing shall be in
				writing and shall be filed with the department of administration's division of
				hearings and appeals within 45 days after the date of notice of denial of
				reimbursement or termination of certification. A request for a hearing is
				considered filed upon its receipt by the division of hearings and appeals.
Note:
The mailing address of the Division of
				  Hearings and Appeals is P.O. Box 7875, Madison, Wisconsin
				  53707.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.05 - Certification of renal transplantation centers, dialysis centers and dialysis facilities

Current through June 24, 2024
(1) CERTIFICATION. For purposes of
				reimbursement, all ESRD units in Wisconsin that are certified under medicare
				shall be considered certified by the department and shall comply with the
				requirements of this chapter.
(2)
				BORDER STATE ESRD UNITS. A border state ESRD unit that provides medical care
				services to Wisconsin residents shall be considered certified by the department
				as a provider if it is certified under medicare. These out-of-state ESRD units
				shall be subject to this chapter and the same contractual agreements as
				Wisconsin ESRD units.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.06 - Provider reimbursement

Current through June 24, 2024
(1) CLAIM FORMS.
(a) A provider shall use claim forms
				furnished or prescribed by the department or its fiscal agent, except that a
				provider may submit claims by electronic media or electronic transmission if
				the provider or billing service is approved by the department for electronic
				claims submission.
(b) Claims shall
				be submitted in accordance with the claims submission requirements, claim form
				instruction and coding information provided by the department or its fiscal
				agent.
(c) Every claim submitted
				shall be signed by the provider or the provider's authorized representative,
				certifying to the truthfulness, accuracy and completeness of the
				claim.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.065 - Patient liability

Current through June 24, 2024
(1) CALCULATION.
(a) A certified patient's liability to
				contribute toward the cost of treatment shall be calculated as follows:
1. If the patient's estimated total family
				income for the current year exceeds 300% of the federal poverty guidelines, the
				patient is liable to obligate or expend a portion of that income, as specified
				in sub. (2), to pay the medical expenses for treatment of kidney disease before
				the CRD program will provide assistance in paying for treatment;
2. The patient is liable for any deductible
				under sub. (3);
3. The patient is
				liable for a coinsurance amount based on the amount reimbursable by the CRD
				program and family size and income in accordance with sub. (4) and Table
				152.065;
4. The sum of the
				patient's deductibles under sub. (3) and coinsurance obligation under sub. (4)
				in a year may not exceed the applicable percentage of income limit in sub. (5)
				unless the annual deductibles under sub. (3) are greater; and
5. In addition, the patient is liable for a
				copayment amount under sub. (6) when the pharmacy bills the CRD
				program.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.07 - Standards for renal transplantation centers

Current through June 24, 2024
(1) GENERAL. To be
				reimbursed by the CRD program, renal transplantation centers shall comply with
				the standards in this section.
(2)
				STAFFING. A renal transplantation center shall have the following staff:
(a) A transplant surgeon;
(b) A nephrologist;
(c) Other physicians licensed in Wisconsin
				or, if employed by an ESRD unit approved under this chapter in a border state,
				in that state, with experience in the following specialties: cardiology,
				endocrinology, hematology, neurology, infectious disease, orthopedics,
				pathology, psychiatry, nuclear medicine, radiology, urology, immunology,
				anesthesiology, gastroenterology, vascular surgery, pediatrics if pediatric
				patients are under care, neurosurgery and cardiovascular surgery;
(d) A nurse;
(e) A dietitian; and
(f) A social worker.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.08 - Standards for renal dialysis centers and facilities

Current through June 24, 2024
(1) GENERAL. To be
				reimbursed by the CRD program, renal dialysis centers and free-standing and
				hospital-based renal dialysis facilities shall comply with the standards in
				this section.
(2) STAFFING. A renal
				dialysis center shall have the following staff and a hospital-based renal
				dialysis facility or a free-standing renal dialysis facility shall make
				available the following staff directly, under arrangement or under agreement:
(a) A nephrologist;
(b) A vascular surgeon;
(c) Other physicians licensed in Wisconsin
				or, if employed by an ESRD unit approved under this chapter in a border state,
				in that state, with experience in the following specialties: cardiology,
				endocrinology, hematology, neurology, psychiatry, urology, orthopedics,
				pathology, pediatrics if children are under care, and radiology;
(d) A nurse;
(e) A dietitian; and
(f) A social worker.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 152 - Reimbursement For Treatment Of Chronic Renal Disease › Section DHS 152.09 - CRD program advisory committee

Current through June 24, 2024
(1) A CRD program
				advisory committee shall be established by the department and shall be given
				staff support by the department. The committee shall consist of 12 Wisconsin
				citizens, as follows:
(a) Four physicians, 2
				of whom are nephrologists and the other 2 transplant surgeons;
(b) One dietician involved in ESRD patient
				care;
(c) Two nurses involved in
				ESRD patient care;
(d) One social
				worker involved in ESRD patient care; and
(e) Four public members.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.01 - Authority and purpose

Current through June 24, 2024
This chapter is promulgated under the authority of ss.
				  49.685(8)
				  (c),
				  49.687(1)
				  and
				  227.11(2),
				  Stats., to implement a program of reimbursement for the cost of blood products
				  and supplies for use in the home care of residents of Wisconsin who have
				  hemophilia.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.03 - Eligibility

Current through June 24, 2024
To be eligible for the hemophilia home care program, a
				  patient shall:
(1) Be a resident of
				Wisconsin;
(2) Be diagnosed by a
				comprehensive hemophilia treatment center as having hemophilia;
(3) Enter into a written agreement with a
				comprehensive hemophilia treatment center for compliance with a maintenance
				program. The agreement shall specify:
(a) The
				services to be provided;
(b)
				Responsibilities of the patient and the center relating to development of the
				plan of treatment and conformance of the patient to applicable center
				policies;
(c) The manner in which
				services are to be controlled, coordinated and evaluated by the center;
				and
(d) Procedures for semi-annual
				evaluation of the maintenance program and for verification that the patient is
				complying with the established treatment regimen; and
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.035 - Termination of eligibility

Current through June 24, 2024
Eligibility under the hemophilia home care program is
				  terminated if any of the following events occur:
(1) The patient dies.
(2) The patient moves out of the state of
				Wisconsin.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.037 - Retroactive eligibility

Current through June 24, 2024
Retroactive eligibility is not available under the hemophilia
				  home care program. Patients who are found to be eligible under s.
				  DHS
				  153.03 become eligible for benefits on the date the
				  application was received.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.04 - Patient certification

Current through June 24, 2024
(1) APPLICATION. To apply for assistance in
				paying for the costs of blood products and supplies used in the home care of
				hemophilia, a patient shall complete a form available from a comprehensive
				hemophilia treatment center, and shall submit the completed form either to the
				center or directly to the department. The completed form shall include a signed
				certification by the physician director of the center that the patient has
				successfully participated in a home care program, and that the physician
				director will review the patient's maintenance program every 6 months and, on
				request of the department, will verify that the patient is complying with the
				program.
(2) NOTIFICATION OF
				APPLICANT. The department shall certify a patient as eligible for reimbursement
				for part of the costs of blood products and supplies used in the home treatment
				of hemophilia if all requirements under s.
				DHS
				153.03 are met. The department shall notify the
				patient, in writing, of its decision within 60 days after the department
				receives an application for assistance. If the application is denied, the
				notice shall include the reason for denial with information that the patient
				may request a hearing under sub. (7) on that decision.
(3) RECERTIFICATION. Certification is for one
				year. To be recertified, a participant shall complete, sign and submit to the
				department a financial statement form received from the department. The
				participant shall provide to the department full, truthful and correct
				information necessary for the department to determine eligibility and
				liability.
(4) REVOCATION OR
				NONRENEWAL OF CERTIFICATION. The department may revoke or not renew a
				participant's certification if the department finds that the participant is no
				longer eligible for the program. The department shall send written notice of
				revocation or nonrenewal to the participant, stating the reason for it and with
				information that the participant may request a hearing under sub. (7) on that
				decision.
(5) PARTICIPANT
				RESPONSIBILITY TO PROVIDE INFORMATION.
(a) A
				participant shall inform the department within 30 days of any change in
				address, other source of health care coverage or family size, or any change in
				income of more than 10%.
(b) The
				department may verify or audit a participant's total family income. The
				department may redetermine a participant's estimated total family income for
				the current year based on a change in the family's financial
				circumstances.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.05 - Provider approval

Current through June 24, 2024
(1) COMPREHENSIVE HEMOPHILIA TREATMENT
				CENTERS.
(a)
Condition.
1. To be reimbursed by the program for blood
				products and supplies, including case management services, provided to program
				participants, a center treating hemophilia patients shall submit an application
				to the department and shall comply with the standards in s.
				DHS
				153.08. Within 60 days after receiving a complete
				application for certification, the department shall either approve or deny the
				application. If the application is denied, the department shall give the
				applicant reasons, in writing, for the denial.
2. As part of its application for
				certification under par. a), a hemophilia treatment center shall execute a
				written agreement with the department to be a comprehensive hemophilia
				treatment center and to receive state reimbursement. This agreement shall,
				unless terminated by either party, remain in full force and effect from the
				date of execution.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 153 - Reimbursement For Blood Products And Supplies UsedIn The Home Care Of Hemophilia › Section DHS 153.06 - Provider reimbursement

Current through June 24, 2024
(1) CLAIM FORMS.
(a) A provider shall use claim forms
				furnished or prescribed by the department or its fiscal agent, except that a
				provider may submit claims by electronic media or electronic submission if the
				provider or billing service is approved by the department for electronic claims
				submission.
(b) Claims shall be
				submitted in accordance with the claims submission requirements, claim form
				instructions and coding information provided by the department or its fiscal
				agent.
(c) Every claim submitted
				shall be signed by the provider or the provider's authorized representative,
				certifying to the truthfulness, accuracy and completeness of the
				claim.