Public Notice
Department of Health and Family Services
(Medical Assistance Reimbursement for Pharmaceutical Products:
Incentive Payments for Substituting Less Expensive Drugs)
The State of Wisconsin reimburses providers for pharmaceutical products 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 and Family Services, is called Medical Assistance (MA) or Medicaid. 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 Wisconsin Department of Health and Family Services is proposing to modify the reimbursement for drugs by paying an incentive dispensing fee through the Pharmaceutical Care Codes to pharmacists for contacting prescribing providers to recommend that their orders be changed to a clinically appropriate but less expensive drug.
The Department's proposal involves no change in the drugs available to recipients of Medical Assistance. The benefits to recipients remain the same as are presently available.
The Department is changing its methods and standards in this manner because it will encourage therapeutic substitution, thus serving to reduce costs to the program without reducing the benefits available to recipients.
Proposed Change
The proposed change is to pay an incentive dispensing fee through the Pharmaceutical Care Codes to pharmacists for contacting prescribing providers to change orders to a clinically appropriate but less expensive drug. Pharmacies will be reimbursed this incentive payment only when a change in drugs occurs.
Copies of the Available Proposed Change:
A copy of the proposed change may be obtained free of charge by calling or writing as follows:
Regular Mail
Attention: State Plan Coordinator
Division of Health Care Financing
P.O. Box 309
Madison, WI 53701-0309
Phone
James Johnston
Community Services Section Chief
(608) 267-9474
FAX
(608) 266-1096
Attention: State Plan Coordinator
E-Mail
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
Written comments are welcome. Written comments on the proposed change may be sent by FAX, e-mail, or regular mail to the Division of Health Care Financing. The FAX number is (608) 266-1096.
The e-mail address is
matana@dhfs.state.wi.us. 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 250 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changed methodology based on comments received.
Actions By The Joint Committee For Review of Administrative Rules
Action by the Joint Committee for
Review of Administrative Rules
Dept. of Commerce
(Plumbing, Chs. Comm 82-87)
The Joint Committee for the Review of Administrative Rules met in Executive Session on December 8, 1998 and adopted the following motion:
Comm 83.03 (2): Relating to the discontinuation of use of privately-owned wastewater treatment systems upon the installation of a public system approved by the Department of Natural Resources.
Moved by Representative Gunderson, seconded by Senator Welch that, pursuant to s. 227.26 (2) (d), Stats., and for the reasons set forth in s. 227.19 (4) (d) 6., Stats., the Joint Committee for Review of Administrative Rules suspend the first two sentences of s. Comm 83.03 (2), Wis. Adm. Code.
Ayes (10)
Noes (0)
Motion carried: Rule suspended.
Action by the Joint Committee for
Review of Administrative Rules
Dept. of Natural Resources
The Joint Committee for the Review of Administrative Rules met in Executive Session on December 8, 1998 and adopted the following motion:
DNR Guidance Documents: Relating to determinations of navigability of farm drainage ditches pursuant to s. 30.10 (4) (c), Stats.
Moved by Representative Grothman, seconded by Senator Welch that, pursuant to s. 227.26 (2) (b), Stats., the Joint Committee for Review of Administrative Rules require that the Department of Natural Resources promulgate as an emergency rule, within 30 days, all guidance documents published by the agency that provide direction to agency staff on the determination of navigability of farm drainage ditches.
Ayes (10)
Noes (0)
Motion carried: DNR To Promulgate Rule in 30 Days.
The State of Wisconsin
Department of Administration
Bureau of Integrated Document Services
Document Sales and Distribution Section
P.O. Box 7840
Dated Material. Please Do Not Delay!
