Public Notice: ARPA Rate Increase

Public Notice

Department of Health Services

AMERICAN RESCUE PLAN ACT RATE INCREASE FOR SELECT HOME AND COMMUNITY-BASED SERVICES

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 in effect.

In response to enhanced federal medical assistance percentage (FMAP) obtained via the American Rescue Plan Act of 2021 (ARPA), the Department will be applying 5% increases to fee-for-service Medical Assistance (MA) maximum fee rates for a number of Home and Community-Based services, effective January 1, 2022.

The impacted services are listed below:

•   Alcohol and other drug abuse (AODA) treatment services

•   Home health services

•   Medication therapy management

•   Mental health day treatment

•   Mental health services

•   Nursing (in home)

•   Occupational Therapy (in home)

•   Personal Care

•   Prenatal Care Coordination (PNCC)

•   Physical Therapy (in home)

•   Residential substance use disorder treatment

•   Respiratory care

•   Skilled nursing services (RN/LPN)

•   Speech and language pathology services (in home)

•   Substance use disorder counseling

•   Targeted case management

•   Transportation Services (excluding broker provided non-emergency transportation and ambulance services)

The change to Medicaid, BadgerCare, and BadgerCare Plus is projected to result in increased annual expenditures of $19,300,000 all funds (AF), composed of $12,400,000 federal match (FED) and $6,900,000 state funds/general purpose revenue (GPR), effective January 1, 2022 – December 31, 2022.

Copies of Changes

Copies of the available proposed changes and proposed rates may be obtained free of charge by writing:

Mail:

Chris Thomas

Bureau of Rate Setting

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Phone:

[phone]

Fax:

[phone]

Attention: Chris Thomas

E-Mail:

[e-mail]

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.

The written comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed change based on comments received.