Medicaid Reimbursement

PUBLIC NOTICE

Department of Health Services

(Medicaid Reimbursement for Midwife Services)

The State of Wisconsin reimburses providers for services provided to Medical Assistance recipients under the authority of Title XIX of the Social Security Act and ss. 49.43 to 49.47, Wisconsin Statutes. This program, administered by the State's Department of Health Services (the Department), is called Medical Assistance (MA) or Medicaid. In addition, Wisconsin has expanded this program to create the BadgerCare Plus program under the authority of Title XIX and Title XXI of the Social Security Act and s. 49.471 of the Wisconsin Statutes. Federal statutes and regulations require that a state plan be developed that provides the methods and standards for reimbursement of covered services. A plan that describes the reimbursement system for the services (methods and standards for reimbursement) is now in effect.

Proposed Change in Payment Methods

The Department hereby provides notice of its intent to amend its state plan to reimburse midwifery services when provided by midwives licensed under Wisconsin Statutes, Section 440.982. The “practice of midwifery” means providing maternity care during the antepartum, intrapartum, and postpartum periods.

Impact of Change

This change will give recipients the additional option of obtaining their maternity care from a certified professional midwife who has been granted a license under section 440.982 of the Wisconsin Statutes to engage in the practice of midwifery. Currently, Wisconsin Medicaid and BadgerCare Plus cover maternity care services when provided by physicians and nurse midwives. There is no recipient copayment for maternity care services.

This change is being made in accordance with 2015 Wisconsin Act 55. The changes will become effective January 1, 2017.

Fiscal Impact

It is estimated that these changes will be budget neutral and will have no impact on the projected Medicaid and BadgerCare Plus budget for state fiscal year (SFY) 2017.

Copies of Changes

Copies of the state plan pages implementing this change may be obtained free of charge by calling or writing as follows:

Regular Mail:

Al Matano

Bureau of Fiscal Management

Division of Health Care Access and Accountability

P.O. Box 309

Madison, WI 53701-0309

Fax:

[phone]

Attention: Al Matano

Telephone:

Al Matano

Bureau of Fiscal Management

[phone]

E-Mail:

[e-mail]

Copies of the state plan change will be made available for review at the main office of any county department of social services or human services.

Written Comments

Written comments are welcome. Written comments on the proposed changes may be sent by FAX, e-mail, or regular mail to the Division of Health Care Access and Accountability. The FAX number is [phone]. The e-mail address is [e-mail]. Regular mail can be sent to the above address. All written comments will be reviewed and considered.

The written comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in Room 350 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changed methodology based on comments received.