Copies of Waiver Documents
A copy of waiver documents, including the waiver application once complete, may be obtained from the department at no charge by downloading the documents from http://www.dhs.wisconsin.gov/seniorcare/ or by contacting: Regular Mail
Al Matano
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53707−0309
Phone
Al Matano
(608)267−6848
FAX
(608)261−7792
E−Mail
Analysis Prepared by the Department of Health Services
Statute interpreted: Section 49.688, Wis. Stats. Statutory authority: Section 49.688, Wis. Stats. Explanation of agency authority:
Section 49.688 (11) directs the department to request from the federal Secretary of Health and Human services a waiver, under 42 USC 1315 (a), of federal Medicaid laws necessary to permit the Department of Health Services to conduct a project to expand eligibility for medical assistance, for purposes of receipt of prescription drugs as a benefit. Related statute or rule: N/A.
Plain language analysis:
The State of Wisconsin Department of Health Services (DHS) is requesting a three-year extension of its Section 1115 Demonstration Waiver for the SeniorCare prescription drug assistance program. The waiver assumes the SeniorCare program will operate the same as it currently is today. If any additional changes are required to this program as a result the Wisconsin biennial budget deliberations, the Department will assess the impact of these changes on the waiver renewal timeline. The current waiver is scheduled to expire on December 31, 2015. The State requests that the waiver be extended for an additional three-year period, from January 1, 2016 to December 31, 2018.
History of the Program
On July 1, 2002, The State of Wisconsin received the necessary waiver approvals from the Center for Medicare & Medicaid Services (CMS) to operate a portion of SeniorCare, a prescription drug benefit for seniors, as a five-year demonstration project. Through its partnership with the federal government, the SeniorCare waiver extends Medicaid eligibility through Title XIX to cover prescription drugs as a necessary primary health care benefit.
Population and Numbers Served
The target population for services under this demonstration project is seniors 65 years of age or older with income at or below 200% of the federal poverty level (FPL), which is $23,540 for an individual and $31,860 for a two-person family in 2015. Each month the SeniorCare waiver program serves about 50,000 seniors.
Summary of, and comparison with, existing or proposed federal regulations:
The federal equivalent to SeniorCare is Medicare Part D. SeniorCare is the only program of its kind.
Agency contact person:
Al Matano
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53707−0309
(608)267−6848 (telephone)
(608)261−7792 (fax)
Place where comments are to be submitted and deadline for submission:
Fiscal Estimate
A copy of the full fiscal estimate may be obtained from the department’s contact person listed above upon request.
