19-02 Version of 43.1 Nonfinancial Requirements

Adults who are infected with tuberculosis (TB) and who are not otherwise eligible for full benefit BadgerCare Plus or Medicaid may be eligible for Tuberculosis (TB)-related Medicaid, a special category of Medicaid.

"Infected with TB" means that a physician has examined them and found that one or more of the following diagnoses apply to them:

They are infected with latent or active TB.
They have a positive TB skin test.
They have a negative TB skin test but a positive sputum culture for the TB organism.
They have a negative test for TB, but a physician certifies that they require TB-related drug therapy, surgical therapy, or both.
A physician certifies that they require testing to confirm the presence or absence of TB.

A member’s statement that they have one or more of the above conditions should be accepted unless the information provided is questionable (see Section 9.10 Questionable Items). If questionable, accept any of the following as verification:

A physician's or registered nurse's written confirmation that the person has one or more of the above conditions.
Wisconsin Tuberculosis Record (Form DPH 4756). This card identifies the person and the physician's diagnosis and has the name and telephone number of the treatment provider.

To be eligible for TB-Related Medicaid, a person must also meet the following criteria:

Be a Wisconsin resident (see Chapter 3 Residence)
Be a U.S. citizen or qualified immigrant (see Chapter 4 Citizenship and Immigration Status)
Provide documentation of citizenship and identity or of immigration status (see Section 4.1 U.S. Citizens and Nationals)
Cooperate with establishing medical support and TPL (see Chapter 5 Medical Support and Third Party Liability)
Sign over to the state their rights to payments from a third party for medical expenses (see Section 5.2 Medical Support/Child Support Agency Cooperation)
Meet BadgerCare Plus SSN requirements (see Chapter 6 Social Security Number Requirements)
Cooperate with verification requests when information is mandatory or deemed questionable (see Chapter 9 Verification)

This page last updated in Release Number: 19-02
Release Date: 09/10/2019
Effective Date: 09/01/2019