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Department of Health Services
(Medicaid Reimbursement for Home Health 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 programs 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.
Change in Payment Methods
Among the services provided to recipients of services under Medicaid and BadgerCare Plus are home health services. Currently the Medicaid state plan restricts home health services to services which are actually provided in an individual's home. The restriction on setting will be removed from the state plan.
The change will be effective July 1, 2018, and will apply to claims with dates of service on or after that date. The change to Medicaid and BadgerCare Plus is projected to result in no change in expenditures.
Copies of Changes
Copies of the proposed changes to the Medicaid state plan affecting home health services may be obtained free of charge by calling or writing as follows:
Regular Mail:
Shawn Thomas
Bureau of Benefits Management
Division of Medicaid Services
P.O. Box 309
Room 350
Madison, WI 53701-0309
(608) 266-1096
Attention: Shawn Thomas
Shawn Thomas
Bureau of Benefits Management
(608) 266-9815
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 Medicaid Services. The FAX number is (608) 266-1096. The e-mail address is 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.
Links to Admin. Code and Statutes in this Register are to current versions, which may not be the version that was referred to in the original published document.