Public notices
Department of Health and Family Services
(Medical Assistance Reimbursement of Hospitals)
The State of Wisconsin reimburses hospitals for medical services provided to low-income persons under the authority of Title XIX of the Federal Social Security Act and sections 49.43 to 49.47, Wisconsin Statutes. The Wisconsin Department of Health and Family Services administers this program that is called Medicaid or Medical Assistance (MA). Federal statutes and regulations require state plans, one for outpatient services and one for inpatient services, that provide the methods and standards for paying for hospital outpatient and inpatient services.
State plans are now in effect for the reimbursement of outpatient hospital services and inpatient hospital services. The Department is proposing to make changes to the provisions contained in the inpatient plan effective July 1, 2004 to implement provisions of
2003 Wisconsin Act 33, the 2003-2005 state budget act, and maintain compliance with federal payment limits, and for administrative efficiencies.
Outpatient Hospital Services
Proposed changes in the state plan for reimbursement for outpatient services may include:
Adjustment to methodology for reimbursement of border status hospitals to reimburse them with the same percent of charges as in-state outpatient hospitals were paid for the previous state fiscal year. This changes total outpatient payments by an estimated $2,000,000 all funds, composed of $1,167,451 Fed and $832,549 general purpose revenue (GPR).
Inpatient Hospital Services
Proposed changes in the state plan for reimbursement for inpatient services may include:
1. Elimination of the recognition of loss on fixed assets for cost reporting, as Medicare no longer recognizes this type of loss.
2. Raising the dollar amount for the cutoff between major and minor border status hospitals.
3. Modification of the interim payment rates for critical access hospitals in order to more accurately reflect final costs.
4. Increasing the target funding for the general assistance disproportionate share allowance.
5. Removing provision that guarantees a critical access hospital will keep full DRG payments if DRG payment is greater than their cost.
Implementation of the above changes to the State Plan for inpatient services is expected to increase payments by an estimated $5,139,400 all funds ($3,000,000 Fed, $2,139,400 GPR) for state fiscal year 2004-2005.
Copies of Proposed Changes and Proposed Payment Rates
Copies of the proposed changes will be sent to every county social services or human service department main office where they will be available for public review. For more information, interested persons may fax or write to:
Hospitals, Physicians and Clinics Section
Division of Health Care Financing
P.O. Box 309
Madison, WI 53701-0309
Fax: (608) 266-1096
Written Comments
Written comments on the proposed changes are welcome and should be sent to the above address. The comments received on the changes will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. at:
Division of Health Care Financing
Room 350, State Office Building
One West Wilson Street
Madison, WI
