Wis. Admin. Code DHS § DHS 153.03

Current through November 25, 2024

Section DHS 153.03 - Eligibility

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

(4) Provide to the department or its designated agent full, truthful and correct information necessary for the department to determine eligibility and liability on forms specified by the department. A patient shall be ineligible for financial assistance if he or she refuses to provide information, withholds information, refuses to assist the department in verifying the information or provides inaccurate information. The department may verify or audit an applicant's total family income.

(5) Complete one of the following actions:

(a) 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.

(b) Apply for and receive from the department a waiver from par. (a) for religious reasons. If the department does not approve the request for a waiver, the applicant shall meet the requirements of par. (a).

Wis. Admin. Code Department of Health Services DHS 153.03

Cr. Register, December, 1994, No. 468, eff. 1-1-95; CR 04-051: cr. (5) Register November 2004 No. 587, eff. 12-1-04.

Persons desiring a waiver from the requirements under par. (a) should submit their request to the Division of Public Health, Bureau of Community Health Promotion, Wisconsin Chronic Disease Program, P.O. Box 2659, Madison, WI 53701-2659, or call 1-800-947-9627. Requests must describe the basis of the religious belief that precludes application for benefits under one or more of the programs listed under par. (a).