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sign a Patient's Representative Declaration (F-03436). The incapacitated individual must be admitted to the facility directly from a hospital inpatient unit. A patient's representative can make health care decisions to the same extent as a guardian of a person and enroll in Medicaid and authorize expenditures related to health care to the same extent as a guardian of the estate. The authority of a patient's representative ends if any of the following occurs: • A court appoints a guardian to make decisions for the incapacitated individual • The incapacitated individual is discharged to a setting that in not a facility • A health care power of attorney that was not identified earlier is identified • The individual is determined to be no longer incapacitated See SECTION 9.9.5 POWER OF ATTORNEY, GUARDIANSHIP, CONSERVATOR,OR PATIENT'S REPRESENTATIVE for information on verification requirements. See SECTION 25.5.1.1 SIGNATURES FROM REPRESENTATIVES for information on valid application signatures by a patient's representative. This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 06/01/2026 35.1 Restoration of Benefits If it is determined that a member’s benefits have been incorrectly denied or terminated, their BadgerCare Plus should be restored from the date of the incorrect denial or termination through the time period that they would have remained eligible. If the member was incorrectly denied or terminated for BadgerCare Plus with a premium obligation, the member can be enrolled without a premium for past months. They will only be charged a premium for future months after advance notice can be provided based on adverse action logic. If a member already paid for a BadgerCare Plus covered service, the member must contact their provider to bill BadgerCare Plus for services provided during that time. A BadgerCare Plus provider must refund the amount that BadgerCare Plus will reimburse for the service. The provider may choose to refund up to the full amount billed to the member, but that decision is entirely optional. If it is determined that a premium amount was incorrectly calculated for BadgerCare Plus and would result in a refund for the member, the correct premium amount for each month in which it was incorrect needs to be determined and reported to the fiscal agent's BadgerCare Plus Unit. The fiscal agent will refund the amount of the premium the member overpaid. Occasionally, a BadgerCare Plus member is certified for retroactive Katie Beckett Medicaid or Supplemental Security Income (SSI) Medicaid eligibility for a period of time in which they were also certified for BadgerCare Plus. If the BadgerCare Plus member paid a premium during this time frame, they are entitled to a refund of any BadgerCare Plus premiums that they paid during the retroactive Katie Beckett Medicaid or SSI Medicaid certification period. This page last updated in Release Number: 24-01 Release Date: 04/03/2024 Effective Date: 04/01/2024