Public Notice
Dept. of Health and Family Services
(Medical Assistance Reimbursement for Private Duty Nursing Services:
State of Wisconsin Medicaid Program)
The State of Wisconsin reimburses home health agencies and nurses in independent practice for private duty nursing (PDN) provided for Medical Assistance recipients under the authority of Title XIX of the Social Security Act and ss. 49.43 to 49.497, Wisconsin Statutes. This program, administered by the State's Department of Health and Family Services, is called Medical Assistance (MA) or Medicaid.
Under current law, PDN services provided by limited practice nurses (LPNs) and registered nurses (RNs) are paid the lesser of: (a) their usual and customary charges; or (b) maximum fees established by the Department for each procedure.
The Department is proposing an increase in the maximum fees for reimbursement of private duty nursing services provided to adults who are not assisted by a ventilator under the MA program. The increase for LPNs will be from $18.04 per hour to $21.02 per hour. The increase for RNs will be from $21.76 per hour to $31.53 per hour. Each of these rate increases would take effect on October 16, 2000. The Department's proposal involves no change in the definition of who is eligible to receive the private duty nursing benefit and the benefits remain the same.
It is estimated that this change will increase annual aggregate Medicaid expenditures by $280,880 all funds for the remaining 9 months of state fiscal year (SFY) 2001 ($164,654 federal and $116,226 state GPR).
Proposed Change
The proposed change is to increase the maximum allowable fee for private duty nursing services provided to adults who are not assisted by a ventilator, for LPNs from $18.04 per hour to $21.02 per hour, and for RNs from $21.76 per hour to $31.53 per hour.
Copies of the Proposed Change
A copy of the proposed change may be obtained free of charge by calling or writing as follows:
Regular Mail:
Division of Health Care Financing
P.O. Box 309
Madison, WI 53701-0309
Telephone:
Mary Laughlin, Budget Unit Chief
Telephone: (608) 261-7833
FAX:
FAX: (608) 266-1096
Attention: Mary Laughlin
E-Mail:
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. All written comments received will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily at:
Division of Health Care Financing
Room 350, State Office Building
One West Wilson Street
Madison, WI
Revisions may be made in the proposed changed methodology based on comments received.
The State of Wisconsin
Department of Administration
Bureau of Document Services
Document Sales and Distribution Section
P.O. Box 7840
Dated Material. Please Do Not Delay!
