Wisconsin Code § 49.197

Fraud investigation and reduction and error reduction
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(1m) FRAUD INVESTIGATION. From the appropriations under s. 20.437 (2) (dz) , (kx), (L), (mc), (md), (me), and
(nL), the department shall establish a program to investigate suspected fraudulent activity on the part of recipients of aid to families with dependent children under s. 49.19, on the part of participants in the Wisconsin Works program under ss. 49.141 to
49.161, and, if the department of health services contracts with
the department under sub. (5), on the part of recipients of medical
assistance under subch. IV, food stamp benefits under the food
stamp program under 7 USC 2011 to 2036, supplemental security
income payments under s. 49.77, payments for the support of
children of supplemental security income recipients under s.
49.775, and health care benefits under the Badger Care health
care program under s. 49.665. The department’s activities under
this subsection may include, but are not limited to, comparisons
of information provided to the department by an applicant and information provided by the applicant to other federal, state, and local agencies, development of an advisory welfare investigation
prosecution standard, and provision of funds to county departments under ss. 46.215, 46.22, and 46.23 or multicounty consortia, as defined in s. 49.78 (1) (br), and to Wisconsin Works agencies to encourage activities to detect fraud. The department shall
cooperate with district attorneys regarding fraud prosecutions.
(2) INCENTIVE PROGRAM FOR LOCAL FRAUD DETECTION. (a)
In this subsection:
1. “County department” means a county department under s.
46.22 or 46.23.
2. “Subsidy program” means the child care subsidy program
under s. 49.155.
3. “Tribal governing body” means an elected governing body
of a federally recognized American Indian tribe.
(b) 1. Subject to subd. 2., the department shall by rule establish an incentive program that, using moneys from the allocation
under s. 49.175 (1) (p), rewards county departments, Wisconsin
Works agencies, and tribal governing bodies that administer the
subsidy program for identifying fraud in the subsidy program.
The rules shall specify that a county department, Wisconsin
Works agency, or tribal governing body shall receive, for identifying fraudulent activity under the subsidy program on the part of a
child care provider, an amount equal to the average monthly subsidy payment per child during the prior fiscal year, multiplied by
the number of children participating in the subsidy program for
whom the provider provides care, multiplied by 1.5 months. A
county department, Wisconsin Works agency, or tribal governing
body may use payments received under this subsection for any
purpose for which moneys under the Temporary Assistance for
Needy Families block grant program may be used under federal
law.
2. No later than January 1, 2012, the department shall submit
its plan for the incentive program to the cochairpersons of the
joint committee on finance for review by the committee. If the
cochairpersons of the committee do not notify the department
that the committee has scheduled a meeting for the purpose of reviewing the proposed plan within 14 working days after the date
of the department’s submittal, the department shall promulgate
the rules for the incentive program in accordance with its proposed plan. If, within 14 working days after the date of the department’s submittal, the cochairpersons of the committee notify
the department that the committee has scheduled a meeting for
the purpose of reviewing the proposed plan, the department may
not promulgate the rules for the incentive program unless the
committee approves the proposed plan. If the committee modifies and approves the proposed plan, the department may promulgate the rules for the incentive program only as modified by the
committee.
(3) STATE ERROR REDUCTION ACTIVITIES. The department
shall conduct activities to reduce payment errors in Wisconsin
Works under ss. 49.141 to 49.161 and, if the department of health
services contracts with the department under sub. (5), the Medical Assistance program under subch. IV, the food stamp program
under 7 USC 2011 to 2036, the supplemental security income
payments program under s. 49.77, the program providing payments for the support of children of supplemental security income recipients under s. 49.775, and the Badger Care health care
program under s. 49.665.
(4) COUNTY AND TRIBAL ERROR REDUCTION. If the department of health services contracts with the department under sub.
(5), the department shall provide funds from the appropriation
under s. 20.437 (2) (kx) to counties, multicounty consortia, as defined in s. 49.78 (1) (br), and governing bodies of federally recognized American Indian tribes administering Medical Assistance
under subch. IV, the food stamp program under 7 USC 2011 to
2036, the supplemental security income payments program under
s. 49.77, the program providing payments for the support of children of supplemental security income recipients under s. 49.775,
and the Badger Care health care program under s. 49.665 to offset

administrative costs of reducing payment errors in those
programs.
(5) CONTRACTS FOR MEDICAL ASSISTANCE, FOOD STAMPS,
SUPPLEMENTAL SECURITY INCOME, AND CARETAKER SUPPLEMENT. Notwithstanding s. 49.845 (1) and (2), the department of
health services may contract with the department to investigate
suspected fraudulent activity on the part of recipients of medical
assistance under subch. IV, food stamp benefits under the food
stamp program under 7 USC 2011 to 2036, supplemental security
income payments under s. 49.77, payments for the support of
children of supplemental security income recipients under s.
49.775, and health care benefits under the Badger Care health
care program under s. 49.665 and to conduct activities to reduce
payment errors in the Medical Assistance program under subch.
IV, the food stamp program under 7 USC 2011 to 2036, the supplemental security income payments program under s. 49.77, the
program providing payments for the support of children of supplemental security income recipients under s. 49.775, and the
Badger Care health care program under s. 49.665, as provided in
this section.
(6) REPORTING OF SUSPECTED FRAUDULENT ACTIVITY. (a) 1.
If any employee of the department, a county, or a tribal governing
body reasonably suspects that fraudulent activity as described in
sub. (1m) or (2) (b) has occurred or is occurring, the employee
shall immediately report the facts and circumstances contributing
to that suspicion to the employee’s immediate supervisor.
2. An immediate supervisor who receives a report under
subd. 1. shall immediately evaluate the report to determine
whether there is reason to suspect that the fraudulent activity has
occurred or is occurring. If the immediate supervisor determines
that there is reason to suspect that the fraudulent activity has occurred or is occurring, the immediate supervisor shall immediately report the facts and circumstances contributing to that suspicion to the unit of the department that is responsible for investigating suspected fraudulent activity under sub. (1m). If the immediate supervisor is an employee of the department or of a
county having a population of 145,000 or more, the immediate
supervisor shall also immediately report those facts and circumstances to the sheriff.
3. Except as provided in subd. 2., an immediate supervisor
who receives a report under subd. 1. shall keep the identity of the
reporter confidential. A sheriff or unit of the department that receives a report under subd. 2. shall keep the identity of the employee reporting under subd. 1. and the immediate supervisor reporting under subd. 2. confidential until the sheriff or unit determines that the report merits further investigation. If the sheriff or
unit conducts a full investigation, the sheriff or unit shall keep the
identity of that employee and immediate supervisor confidential
if it is reasonably possible to do so. Any person who fails to report as required in subd. 1. or 2. may be required to forfeit not
more than $1,000.
(b) Any person participating in good faith in the making of a
report under par. (a) 1. or 2. or in initiating, participating in, or
testifying in, any action or proceeding in which fraudulent activity as described in sub. (1m) or (2) (b) is alleged shall have immunity from any liability, civil or criminal, that results by reason of
the action. For the purpose of any proceeding, civil or criminal,
the good faith of any person reporting under par. (a) 1. or 2. shall
be presumed.
(c) The department, a county, a tribal governing body, or an
employee of the department, a county, or a tribal governing body
may not take disciplinary action against, or threaten to take disciplinary action against, any person because the person in good
faith reported any information under par. (a) 1. or 2. or initiated,
participated in, or testified in, any action or proceeding in which
fraudulent activity described in sub. (1m) or (2) (b) was alleged
or because the department, county, tribal governing body, or employee believes that the person in good faith reported any information under par. (a) 1. or 2. or initiated, participated in, or testified in, such an action or proceeding.
(d) Any person who is subjected to disciplinary action, or who
is threatened with disciplinary action, in violation of par. (c) may
file a complaint with the department of workforce development
under s. 106.54 (9). If that department finds that a violation of
par. (c) has been committed, that department may take such action under s. 111.39 as will effectuate the purpose of this section.
Section 111.322 (2m) applies to a disciplinary action arising in
connection with any proceeding under this paragraph.

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