Public Notice: Medicaid Personal Care Services Reimbursement

PUBLIC NOTICE

Department of Health Services

Personal Care Services Maximum Allowable Fee Modification

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.

Personal Care Services Maximum Allowable Fee Modification

Among the services reimbursed for recipients of services under Medical Assistance, BadgerCare, and BadgerCare Plus are personal care services. The Department intends to increase the maximum allowable fees for all personal care services by 14.41%.

The change will be effective January 1, 2020, 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 increased expenditures of $ 55.4 million all funds (AF), composed of $32.9 million federal match (FED) and $22.5 million state general purpose revenue (GPR) in the 2019-21 biennium.

Copies of Changes

Copies of the personal care services maximum allowable fee modification may be obtained free of charge by calling or writing:

Laura Brauer

Bureau of Benefits Management

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

[phone]

Fax:

[phone]

Attention: Laura Brauer

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 Medicaid Services. The FAX number is (608) 266‑1096. 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 change based on comments received.