Public Notice: Medicaid State Plan Amendment

PUBLIC NOTICE

Department of Health Services

Coverage of Services related to COVID-19

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.

Coverage of COVID-19 Treatment, Vaccines, and Testing

The federal American Rescue Plan Act (ARPA) requires Medicaid to cover services related to COVID-19 without cost sharing for Medicaid members during and for one year after the COVID-19 public health emergency. Wisconsin Medicaid already complies with these provisions and has existing State Plan authority for coverage of these services. This amendment to the Medicaid state plan serves as the Department’s attestation to these coverage requirements. These services include:

—Vaccine administration for COVID-19

—Diagnostic and screening testing for COVID-19

—Treatment of COVID-19, post-COVID conditions (aka “long COVID”), and conditions that may seriously complicate the treatment of COVID

Medicaid rates for COVID-19 vaccine administration, testing, and treatment are published in the ForwardHealth maximum fee schedule, which is published on the ForwardHealth provider portal.

Rates established will be active during the period starting March 11, 2021 and ending on the last day of the first calendar quarter that begins one year after the last day of the public health emergency.

Copies of Changes

Copies of the COVID-19 treatment, vaccine, and testing reimbursement modifications can be obtained free of charge by:

Mail:

Bailey Dvorak

State Plan Coordinator

Bureau of Benefits Policy

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Fax:

[phone]

Attention: Medicaid State Plan Coordinator

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.

Requests to review written comments received may be submitted to the Division of Medicaid Services as described above. Revisions may be made in the proposed change based on comments received.