Publice Notice: CHIP Managed Care

PUBLIC NOTICE

Department of Health Services

CHIP Managed Care

The State of Wisconsin reimburses providers for services 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 Services (the Department), is called Medical Assistance (MA) or Medicaid. In addition, Wisconsin has expanded this program to create the BadgerCare Plus programs under the authority of Title XIX and Title XXI of the Social Security Act and s. 49.471 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.

Change in CHIP Managed Care

In 2016, CMS made changes to federal managed care rules. In order to remain in compliance with federal rules, the Children’s Health Insurance Program (CHIP) Child Health Plan authorized by Title XXI of the Social Security Act is implementing these changes over the course of several years, including changes to encounter data, member rights, oversight, provider network adequacy, quality reporting, and rates development. The Department is updating the CHIP Child Health Plan to align with these federal rule changes and Department policies and procedures.

The change will be effective July 1, 2018 and is projected to result in no change in expenditures.

Copies of Changes

Copies of the program plans may be obtained free of charge by calling or writing as follows:

Regular Mail:

Laura Brauer

Bureau of Benefits Management

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Fax:

[phone]

Attention: Laura Brauer

E-Mail:

[e-mail]

Copies of the state plan change will be made 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 changes may be sent by FAX, e-mail, or regular mail to the Division of Medicaid Services. The FAX number is [phone]. The e-mail address is [e-mail]. 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 350 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changed methodology based on comments received.