Public Notice: Medical Assistance Reimbursement of Nursing Homes

PUBLIC NOTICE

Department of Health Services

(Medical Assistance Reimbursement of Nursing Homes)

State of Wisconsin Medicaid Nursing Facility Methods of Implementation

The State of Wisconsin reimburses Medicaid-certified nursing facilities for long-term care and health care services provided to eligible persons under the authority of Title XIX of the Federal Social Security Act and ss. 49.43 to 49.47, Wisconsin Statutes. This program, administered by the State's Department of Health Services, is called Medical Assistance (MA) or Medicaid. Federal Statutes and regulations require that a state plan be developed that provides the methods and standards for setting payment rates for nursing facility services covered by the payment system. A plan that describes the nursing home reimbursement system for Wisconsin is now in effect as approved by the Centers for Medicare and Medicaid Services (CMS).

The Department is proposing changes in the methods of implementation to nursing homes and, therefore, in the plan describing the nursing home reimbursement system.

This notice represents information known as of December 12th, 2022.

The proposed changes are as follows:

1. Modify Sec. 1.10 of the methodology as it relates to the number of months a cost report and supporting documentation are required after a facility’s cost reporting period.

2. Remove Sec. 7.30 – Calculation of Medicare Upper Limit of the methodology and remove references thereto, and renumber Secs. 7.40 through 7.90 accordingly.

The change will be effective January 1, 2023. The change to Medicaid, BadgerCare, and BadgerCare Plus is projected to result in increased annual expenditures of $0 all funds (AF), composed of $0 federal match (FED) and $0 state funds/general purpose revenue (GPR).

Copies of the Proposed Changes:

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

Mail: Bailey Dvorak

Bureau of Benefits Policy

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Phone: [phone]

Fax: [phone]

Attention: Bailey Dvorak

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.

Because the State Office Building at 1 West Wilson Street, Madison, Wisconsin is currently closed to the public, written comments will not be available for in person public review. 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.