Public Notice: Section 1115 Postpartum Coverage Waiver

Wisconsin Department of Health Services

Section 1115 Postpartum Coverage Waiver

Overview

The Department of Health Services (DHS) intends to submit an application to the Centers for Medicare and Medicaid Services (CMS) on or around May 15, 2022, requesting a five-year Medicaid 1115 Research and Demonstration Waiver as required by 2021 Wisconsin Act 58. The waiver will allow the state to extend postpartum Medicaid coverage from 60 days to 90 days or three months, effectively providing an additional month of coverage for birthing people whose household income is above 100% of the federal poverty level (FPL). DHS must obtain approval from CMS before this change can take effect.

Demonstration Population

The waiver will extend the postpartum coverage period from 60 days to 90 days postpartum for eligible birthing people whose household income is above 100% but not exceeding 300% of FPL. The waiver will only be implemented for the following eligibility groups:

—Qualified Pregnant Women and Children – 42 CFR § 435.116, SSA § 1902(a)(10)(A)(i)(III), SSA § 1905(n)

—Mandatory Poverty Level Pregnant Women — SSA § 1902(a)(10)(A)(i)(IV), SSA § 1902(l)(1)(A)

—Optional Poverty Level Related Pregnancy – Women & Infants - SSA § 1902(a)(10)(A)(ii)(IX), SSA § 1902(l)(2)

Eligibility

Eligibility for the extended postpartum period is determined by the date on which the pregnancy ends. This extension has no material impact on eligibility determinations.

Public Comment  

Providing information and obtaining input on changes from the public is of high importance for the state as we prepare to submit the request. By law, you have the opportunity to review the official waiver application and to provide comments for 30 days, starting April 6, 2022, and ending May 6, 2022. You may also provide comments through written or verbal statements during public hearings (see below). Public comments will be included in the waiver request submitted to CMS on or around May 15, 2022, and will be available on DHS’s website at the address listed below.

Public Hearings

Due to the public health concerns related to the COVID-19 pandemic, the state will not be conducting in-person meetings as part of the public notice process for this waiver application. CMS has the discretion to exempt the state from completing any aspect of the public notice process. Exemption reasons include demonstration by the state to CMS the existence of unforeseen circumstances, such as the COVID-19 public health emergency, that directly threaten human lives and warrant an exception to the normal public notice process. Accordingly, the state will hold two webinars instead of in-person hearings.

 

—April 13, 2022, 10:00 a.m. – 12:00 p.m.

—Join online:

https://dhswi.zoomgov.com/w/1616690151

—Join by phone:

—Toll-Free: 844-708-2568

—669-254-5252

—646-828-7666

—669-216-1590

—551-285-1373

—Webinar ID: 161 669 0151

—April 20, 2022, 10:00 a.m. – 12:00 p.m.

—Join online:

https://dhswi.zoomgov.com/j/1610547719

—Join by phone:

—Toll-Free: 844-708-2568

—669-254-5252

—646-828-7666

—669-216-1590

—551-285-1373

—Webinar ID: 161 054 7719

Copies of Waiver Documents

Copies of waiver documents, including the full public notice (to be posted on April 6, 2022), and the final waiver application once complete, may be obtained from DHS at no charge. by downloading the documents at www.dhs.wisconsin.gov/dms/postpartum1115waiver.htm or by contacting Bailey Dvorak at:

Mail:   Bailey Dvorak

  Division of Medicaid Services

P.O. Box 309

Madison, WI 53707-0309

Phone: [phone]

Fax: [phone], Attn: Bailey Dvorak