Health and Family Services
(Medical Assistance Services in the Schools)
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
, Wisconsin Statutes. This program, administered by the State's Department of Health and Family Services, is called Medical Assistance (MA) or Medicaid. 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.
The Wisconsin Department of Health and Family Services is proposing to modify provisions of the State plan relating to billing Medicaid for services provided to eligible recipients in the schools.
The Department has submitted a Medicaid state plan amendment for approval by the federal Centers for Medicare and Medicaid Services (CMS) to allow providers to bill for all Medicaid coverable services provided in the schools to students who are eligible for Medicaid. Under this change, an individualized education program, or IEP, is no longer a prerequisite to bill Medicaid for services provided in the schools. The reimbursement methodology will be identical to the reimbursement methodology currently used by Medicaid for IEP services. Under the plan amendment providers will be able to bill Medicaid for all services for which Medicaid reimbursement is available under federal law that are provided to Medicaid-eligible recipients in the schools.
The projected fiscal effect of these changes for state fiscal year (SFY) 2004 is $1,242,715, composed of $725,000 federal share, or FED, and $517,715 in general purpose revenues, or GPR. For SFY 2005 the projected fiscal impact is $4,970,860 all funds, composed of $2,900,000 FED and $2,070,860 in GPR.
The changes will apply to services provided in the schools on or after July 1, 2004.
Copies of the Proposed Changes
A copy of the proposed changes may be obtained free of charge by calling or writing as follows:
Marge Hannon Pifer
Bureau of Fee-for-Service Health Care Benefits
Division of Health Care Financing
P.O. Box 309
Madison, WI 53701-0309
Marge Hannon Pifer
Attention: Marge Hannon Pifer
A copy of the proposed changes are available for review at the main office of any county department of social services or human services.
Written comments are welcome. Written comments on the proposed changes may be sent by FAX, e-mail, or regular mail to the Department. The FAX number is (608) 266-1096.
The e-mail address is email@example.com
. 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.
Notice of Availability of a Legislative Report Relating to Wisconsin's Designation of Ten Counties as Nonattainment for the Eight-Hour Ozone Standard.
All interested persons are advised that the Department of Natural Resources (DNR) is proposing to issue a document designating 10 counties (Door, Kenosha, Kewaunee, Manitowoc, Milwaukee, Ozaukee, Racine, Sheboygan, Washington and Waukesha)as nonattainment for the eight-hour ozone standard. The Department has submitted a report on the proposed designations to the legislative standing committees for environmental matters as required under s. 285.23(6)
, Stats. If you would like copies of the information supplied to the Wisconsin legislative committees, please call Marney Hoefer, DNR, at 608-267-0577 or send a request via email to Margaret.Hoefer@dnr.state.wi.us