3. Modify Sections 3.220, 3.500, 3.700 and 5.300 through 5.900, as applicable, to adjust as may be necessary the payment parameters, factors, targets, maximums, increments and indices.
4. Modify the plan amendment to eliminate Section 7.000 since this section does not apply to the revised system for the plan amendment year. This includes the sample rate calculation included as part of the plan amendment, the policy on applicable formula maximums drafted to clarify the implementation of the Section 7.000 rate on rate payment system, and references to Section 7.000 throughout the plan amendment.
5. Amend Section 1.241 to clarify the use of “allowable” worker's compensation costs in self-insurance plans under Section 1.248.
6. Modify Section 1.600 to clarify that prior year Ch. 150 rates effective as maximums at time of plan amendment remain in effect and to update the citations relating to ch. 150, Stats., and ch. HFS 122.
7. Modify Section 3.254 relating to exceptional Medicaid utilization adjustment to clarify when payment adjustment is effective when ownership changes.
8. Amend Section 3.525 (a) to change the useful life reference from Medicare guidelines to American Hospital Association guidelines.
9. Amend Section 3.525 on depreciation and amortization policy, Section 3.526 on interest expense, Section 3.526 (c) and (d) on systematic reduction of debt, and related provisions in Section 3.500 specifically to clarify, as needed, the policies regarding letters of credit which may not be addressed currently in the plan amendment.
10. Amend Section 3.526 (c) on interest expense relating to reduction of debt to assure that reduction of debt is required.
11. Amend Section 3.526 (d) on interest expense relating to refinancing of debt to assure that the plan amendment addresses bonding letters of credit.
12. Eliminate Section 3.013 (b) to exempt homes with phase-down agreements from minimum occupancy requirement.
13. Modify Section 4.520 relating to payment rates during a phase-down period to explicitly state that the Section 3.500 property allowance is included in the minimum patient days calculation.
14. Modify Section 1.500 on billing for bed hold relating to the criteria for billing and to eliminate Sections 1.530 (1) and (2) exclusions for determining the licensed beds for billing.
15. Amend Section 4.850 relating to payment for services to permit payment of the facility's daily rate to the evacuated-use sites during the evacuation period and to allow a retrospective settlement or calculation for determination of, and payment for, extraordinary expenses.
16. Modify Section 5.430 relating to the labor regions for the direct care allowances to reflect a revised methodology and a rebasing of the labor regions.
17. Amend Section 3.529 on energy savings projects relating to project incentives.
18. Modify Section 3.537 on the maximum allowable decrease for the property allowance to clarify, if necessary, that the allowance in effect was the allowance calculated in the 1995-96 payment rates.
19. Create Section 3.776 describing the use of supplementary funding for local government-owned facilities which are either closing or being sold.
20. Modify Section 4.501 to prohibit facilities using Section 3.776 from receiving a special payment rate for significant decreases in licensed beds.
21. Modify Section 5.210 to reference allowable over-the-counter drugs.
22. Amend Section 2.500 as follows to describe what the property payment allowance covers beyond the value of the buildings.
23. Amend Section 1.270 to clarify revenues from invested funds.
24. Modify Section 4.120 to redefine material adjustments for this payment system.
25. Move payment-related parameters from Section 3.000 to Section 5.000.
26. Amend the Methods to renumber certain Sections, specifically 2.600-2.650, 2.800, 3.800, and 3.600.
27. Amend the plan amendment as appropriate to effect any changes necessary related to the above modifications to assure that the intent and the purpose of the above changes are achieved.
Proposed change to take effect January 1, 1998 (advance public notice)
1. Modify Section 5.164 relating to covered services, waivers and variances, and prior authorization to encourage the use of the most cost-effective durable medical equipment for the prevention and treatment of pressure relief sores, pressure sores, and decubiti.
Copies of the Available Proposed Changes
Copies of the available proposed changes may be obtained free of charge by calling or writing as follows:
Phone (608) 267-9595
FAX (608) 266-1096 -- (Attention: Nursing Home Medicaid Payment Plan)
Regular Mail
Attention: Nursing Home Medicaid Payment Plan
Bureau of Health Care Financing
Division of Health
P.O. Box 309
Madison, WI 53701-0309
E-Mail
Copies of the available proposed changes will be available for review at the main office of any county department of social services or human services from July 15 through at least September 1.
Since changes will be continuously developed during the public comment period, additional materials will be developed and will be available through the options above or by attending the public meetings. If you request copies of the proposed changes, you will receive a copy of the final changes or the final plan amendment.
Before finalizing the plan amendment, the Department may modify its proposed changes after considering the comments received during the public comment period. The plan amendment will not be submitted to the federal government until after the public comment period and will be effective retroactively to July 1, 1997.
Written Comments
Except for the public meetings, only written comments will be considered. Written comments on the proposed changes may be sent by FAX, E-mail, or regular mail to the Bureau of Health Care Financing. The FAX number is (608) 266-1096. The E-mail address is:
JEHLDJ@DHFS.STATE.WI.US (
must use caps). Regular mail may 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 250 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changes, based on comments received.
Public Meetings
There will also be public meetings to seek input on the proposed plan amendment. If you would like to be sent a public meeting notice, please fax or write using the above addresses. The proposed changes may be revised, based on comments received at these forums.
The State of Wisconsin
Department of Administration
Document Sales Unit
P.O. Box 7840
Dated Material. Please Do Not Delay!
