Wisconsin Statutes Social Services (Ch. 46 to 58) § 49.465. Presumptive medical assistance eligibility

(1) In this section, “qualified provider” means a provider which satisfies the requirements under 42 USC 1396r-1(b)(2), as determined by the department.

(2) A pregnant woman is eligible for medical assistance benefits, as provided under sub. (3), during the period beginning on the day on which a qualified provider determines, on the basis of preliminary information, that the woman's family income does not exceed the highest level for eligibility for benefits under s. 49.46(1) or 49.47(4)(am) or (c)1. and ending as follows:

(3) The department shall audit and pay allowable charges to a provider certified under s. 49.45(2)(a) 11. for medical assistance on behalf of a recipient under this section only for ambulatory prenatal care covered under s. 49.46(2).

(4) A woman who is determined to be eligible under this section shall apply for benefits under s. 49.46 or 49.47 on or before the last day of the month following the month in which the qualified provider makes that determination.

(5) A qualified provider which determines that a woman is eligible under this section shall do all of the following:

(6) The department shall provide qualified providers with application forms for medical assistance under ss. 49.46 and 49.47 and information on how to assist women in completing the forms.