Public Notices
Health Services
Medicaid Reimbursement for Outpatient Hospital Services:
Psychiatric Hospitals
State of Wisconsin Medicaid Payment Plan for State Fiscal Year 2013-2014
The State of
Wisconsin reimburses providers for services provided to Medical Assistance recipients, including hospitals, 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 (DHS), is called Medical Assistance (MA) or Medicaid. In addition,
Wisconsin has expanded this program to create the BadgerCare and BadgerCare Plus programs under the authority of
Title XIX and
Title XXI of the Social Security Act and ss.
49.471,
49.665, and
49.67 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.
The following changes will be contained in the October 1, 2013 outpatient hospital state plan amendment:
• Supplemental payments will be made to the county-owned psychiatric hospital(s) in the state. The amount of the payments will equal the difference between the current rates and their cost of providing services to Medicaid patients.
This notification is intended to provide notice of the type of changes that are included in the amendment. Interested parties should obtain a copy of the actual proposed plan amendment to comprehensively review the scope of all changes.
Proposed Change
It is estimated that these changes will have a projected impact of increased annual Medicaid expenditures in the amount of $1,000,000 all funds, composed of $409,400 in county certified public expenditures and $590,600 in federal match.
The Department's proposal involves no change in the definition of those eligible to receive benefits under Medicaid, and the benefits available to eligible recipients remains the same. The effective date for these proposed changes will be October 1, 2013.
Copies of the Proposed Change
A copy of the proposed change may be obtained free of charge at your local county agency or by calling or writing as follows:
Regular Mail
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53701-0309
State Contact
Al Matano
Bureau of Fiscal Management
(608) 267-6848 (phone)
(608) 266-1096 (fax)
A copy of the proposed change is available for review at the main office of any county department of social services or human services.
Written Comments
W
ritten comments are welcome. W
ritten comments on the proposed change may be sent by F
AX, email, or regular mail t
o the
Division of Health Care Access and Accountabilit
y. T
he FAX number
is (608) 266-1096. T
he email address is alfred.matano@wisconsin.gov. R
egular mail can be
sent t
o the a
bove address. A
ll written comments will be reviewed and considered. All written comments received 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 W
est W
ilson Street, Madison, W
isconsin. Revisions may be made in the proposed changed methodology based on comments received.
Health Services
Medicaid Reimbursement for Inpatient Hospital Services:
Psychiatric Hospitals
State of Wisconsin Medicaid Payment Plan for State Fiscal Year 2013-2014
The State of
Wisconsin reimburses providers for services provided to Medical Assistance recipients, including hospitals, 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 (DHS), is called Medical Assistance (MA) or Medicaid. In addition,
Wisconsin has expanded this program to create the BadgerCare and BadgerCare Plus programs under the authority of
Title XIX and
Title XXI of the Social Security Act and ss.
49.471,
49.665, and
49.67 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.
The following changes will be contained in the October 1, 2013 inpatient hospital state plan amendment:
• Supplemental payments will be made to the county-owned psychiatric hospital(s) in the state. The amount of the payments will equal the difference between the current rates and their cost of providing services to Medicaid patients.
This notification is intended to provide notice of the type of changes that are included in the amendment. Interested parties should obtain a copy of the actual proposed plan amendment to comprehensively review the scope of all changes.
Proposed Change
It is estimated that these changes will have a projected impact of increased annual Medicaid expenditures in the amount of $1,200,000 all funds, composed of $491,280 in county certified public expenditures and $708,720 in federal match.
The Department's proposal involves no change in the definition of those eligible to receive benefits under Medicaid, and the benefits available to eligible recipients remains the same. The effective date for these proposed changes will be October 1, 2013.
Copies of the Proposed Change
A copy of the proposed change may be obtained free of charge at your local county agency or by calling or writing as follows:
Regular Mail
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53701-0309
State Contact
Al Matano
Bureau of Fiscal Management
(608) 266-2469 (phone)
(608) 266-1096 (fax)
A copy of the proposed change is available for review at the main office of any county department of social services or human services.
Written Comments
W
ritten comments are welcome. W
ritten comments on the proposed change may be sent by F
AX, email, or regular mail t
o the
Division of Health Care Access and Accountabilit
y. T
he FAX number
is (608) 266-1096. T
he email address is alfred.matano@wisconsin.gov. R
egular mail can be
sent t
o the a
bove address. A
ll written comments will be reviewed and considered. All written comments received 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 W
est W
ilson Street, Madison, W
isconsin. Revisions may be made in the proposed changed methodology based on comments received.
Health Services
Medicaid Reimbursement for Physician and Non-Physician Professional Services:
State of Wisconsin Medicaid Payment Plan for State Fiscal Year 2013-2014
The State of
Wisconsin reimburses providers for services provided to Medical Assistance recipients, including physicians and non-physician professionals, 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 (DHS), is called Medical Assistance (MA) or Medicaid. In addition,
Wisconsin has expanded this program to create the BadgerCare and BadgerCare Plus programs under the authority of
Title XIX and
Title XXI of the Social Security Act and ss.
49.471,
49.665, and
49.67 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.
The following changes will be contained in the October 1, 2013 physician services state plan amendment:
• Quarterly supplemental payments for services provided to physician and non-physician professionals who are members of medical practice group either employed by or contracted with the a state-owned hospital or a non-state public psychiatric hospital located in the state in order to recognize the unique role of these providers in the State Medicaid healthcare delivery system. The amount of the supplemental payment will be the difference between the current rate for services and the average commercial rate.
This notification is intended to provide notice of the type of changes that are included in the amendment. Interested parties should obtain a copy of the actual proposed plan amendment to comprehensively review the scope of all changes.
Proposed Change
It is estimated that these changes will have a projected impact of increased annual Medicaid expenditures in the amount of $151,000 all funds, composed of $61,000 in county certified public expenditures and $90,000 in federal match.
