CR 24-025 Rule Text

SECTION 2. DHS 115.04 (13m) is created to read:

DHS 115.04 (13m) Hypermethioninemia (MET) ICD-10-CM- E72.19.

SECTION 3. DHS 115.04 (15) (c), (e), and (i) are amended to read:

DHS 115.04 (15) (c) Methylmalonic acidemia (CBL A, B, C, D; MUT) (cobalamin disorders) and methylmalonyl-CoA mutase deficiency, ICD−10−CM−E71.120.

DHS 115.04 (15) (e) 3-Methylcrotony1-CoA carboxylase deficiency 2-Methyl-3-hydroxybutyric aciduria, ICD-10-CM-E71.19

DHS 115.04 (15) (i) 2-Methyl-3-hydroxbutyric aciduria 3-Methylcrotonyl-CoA carboxylase deficiency, ICD-10-CM-E71.19.

SECTION 4. DHS 115.04 (17) is repealed and recreated to read:

DHS 115.04 (17) Lysosomal disorders, including all of the following:

a) Pompe Disease ICD−10−CM−E74.02

b) Mucopolysaccharidosis I ICD-10-CM-E76.0

SECTION 5. DHS 115.04 (18) is created to read:

DHS 115.04 (18) X-Linked Adrenoleukodystrophy (X-ALD), ICD-10-CM-E71.52

SECTION 6. DHS 115.055 is renumbered DHS 115.055 (2) and amended to read:

DHS 115.055 (2) Calculation of fees. The newborn screening sample collection card fee for testing a newborn under s. 253.13 (1), Stats., and this chapter shall be $109 $223 as of [LRB to insert effective date of rule] to cover the costs of testing and to fund follow−up services and other activities under s. 253.13 (2), Stats. Thereafter, the fee charged under this section shall be adjusted by the department on July 1 of each odd numbered year based on the average of the three most recently published Medicare economic indexes.

SECTION 7. DHS 115.055 (1) is created to read:

DHS 115.055 (1) Definition. In this section, “Medicare economic index” means the price index authorized under 42 USC 1395u (b) (3), and computed and published in accordance with 42 CFR 405.504 (d).

SECTION 8. EFFECTIVE DATE. This rule takes effect on the first day of the month following publication in the Wisconsin Administrative Register as provided in s. 227.22 (2) (intro.), Stats.

1

The Medicare Economic Index is authorized under 42 USC 1395u (b) (3), which states that states that prevailing charge levels beginning after June 30, 1973 may not exceed the level from the previous year except to the extent that the Secretary finds, on the basis of appropriate economic index data, that the higher level is justified by year-to-year economic changes. The Centers for Medicare and Medicaid Services develop and update the Medicare Economic Index, expressed as a percentage. See 42 CFR 405.409 (d); 87 Fed. Reg. 45860 (July 29, 2022), available at https://www.federalregister.gov/documents/2022/07/29/2022-14562/medicare-and-medicaid-programs-cy-2023-payment-policies-under-the-physician-fee-schedule-and-other.