Public Notice: Reimbursement Adjustment

PUBLIC NOTICE

Department of Health Services

Reimbursement adjustment to Non-Emergency Medical Transportation (NEMT):
Effective November 1, 2021

The Wisconsin Department of Health Services (DHS) Division of Medicaid Services (DMS) will be implementing a reimbursement adjustment to Non-Emergency Medical Transportation (NEMT), effective November 1, 2021, as a result of a new contract to provide NEMT services for Wisconsin Medicaid and BadgerCare Plus members.

DHS will pay a fixed administrative amount per month and reimburse full direct costs. In addition, the new contractor may earn an incentive payment if they are able to lower the direct cost per trip from the direct cost per trip of the most recent 12 month period. This incentive payment will be calculated on a quarterly basis by multiplying the savings per trip by the number of trips in that quarter.

Fiscal Impact

It is estimated that in Federal Fiscal Year 2022 this new contract will be $ 80,356,078.44 all funds (AF), composed of $ 27,256,781.81 state funds/general purpose revenue (GPR) and $ 53,099,296.63 federal match (FED).

Copies of Changes

Copies of the state plan change may be obtained free of charge by calling or writing as follows:

Mail:

Laura Brauer

Bureau of Benefits Policy

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Phone:

[phone]

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 as described above. All written comments will be reviewed and considered.