Section DHS 108.03 - County responsibilities(1) DETERMINATION OF ELIGIBILITY. Agencies shall be responsible for determination of eligibility for MA. These determinations shall comply with standards for eligibility found in ss. 49.46 (1), 49.47 (4), and 49.665 (4), Stats., and ch. DHS 103.(2) INFORMING RECIPIENTS OF RIGHTS AND DUTIES. Agencies shall inform recipients of the recipients' rights and duties under the program, including those rights enumerated in s. DHS 106.04(3).(3) RECOVERY OF INCORRECT PAYMENTS. (a) Agencies shall begin recovery action, as provided by statute for civil liabilities, on behalf of the department against any MA recipient to whom or on whose behalf an incorrect payment was made.(b) The incorrect payment shall have resulted from a misstatement or omission of fact by the person supplying information during an application for MA benefits, or failure by the recipient, or any other person responsible for giving information on the recipient's behalf, to report income or assets in an amount which would affect the recipient's eligibility for benefits.(c) The amount of recovery may not exceed the amount of the MA benefits incorrectly provided.(d) Records of payment for the period of ineligibility, provided to the agency by the MA fiscal agent, shall be evidence of the amounts paid on behalf of the recipient.(e) The agency shall notify the recipient or the recipient's representative of the period of ineligibility and the amounts incorrectly paid, and shall request arrangement of repayment within a specified period of time.(f) If the effort to recover incorrect payments under par. (e) is not successful, the agency shall refer cases of possible recovery to the district attorney or corporation counsel for investigation and the district attorney or corporation counsel may bring whatever action may be appropriate for prosecution for fraud or collection under civil liability statutes. Judgments obtained in these actions shall be filed as liens against property in any county in which the recipient is known to possess assets, if not satisfied at the time the judgment or order for restitution is rendered. Execution may be taken on the judgments as otherwise provided in statute.(g) The agency may seek recovery through an order for restitution by the court of jurisdiction in which the recipient or former recipient is being prosecuted for fraud.(h) The agency's decision concerning ineligibility and amounts owed may be appealed pursuant to ch. HA 3. During the appeal process the agency may take no further recovery actions pending a decision. Benefits shall be continued pending the decision on the appeal. When the hearing decision is subsequently adverse to the client the benefits paid pending a decision on the appeal shall be collectable as incorrect payments.(i) The agency shall immediately deposit monies collected under this subsection to a designated bank account. The collection shall be reported to the department in the manner and on forms designated by the department within 30 days following the end of the month in which the collection is made, and shall be transmitted to the state in accordance with departmental instructions.Wis. Admin. Code Department of Health Services DHS 108.03
Cr. Register, December, 1979, No. 288, eff. 2-1-80; renum. from HSS 108.02 and am. Register, February, 1986, No. 362, eff. 3-1-86; cr. (6), Register, December, 1988, No. 396, eff. 1-1-89; r. (4), renum. (5) and (6) to be (4) and (5), Register, September, 1991, No. 429, eff. 10-1-91; correction in (5) made under s. 13.93(am) (b) 7, Stats., Register, September, 1991, No. 429; correction in (3) (h) made under s. 13.93(2m) (b) 7, Stats., Register, May, 1995, No. 473; emerg. am. (1), eff. 7-1-99; am. (1), Register, March, 2000, No. 531, eff. 4-1-00; corrections in (3) (h) and (4) made under s. 13.93(2m) (b) 7, Stats., Register February 2002 No. 554; corrections in (1), (2) and (4) made under s. 13.92(4) (b) 7, Stats., Register December 2008 No. 636.Amended by, CR 18-046: r. (5) Register January 2019 No. 757, eff. 2/1/2019Amended by, CR 23-046: r. (4) Register April 29 No. 820, eff. 5/1/2024