Public Notice: Wisconsin Medicaid Access Payment Updates

PUBLIC NOTICE PUBLIC NOTICE

Department of Health Services

Wisconsin Medicaid Access Payment Updates

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.

Change in Covered Services and Payment M Change in Covered Services and Payment Methods

The Department is making the following changes to the sections in Wisconsin’s Medicaid Hospital Inpatient State Plan (Attachment 4.19-A).

• • Inpatient Access Payments:

• o DHS will modify §9700 Inpatient Access Payments to remove long term acute care (LTAC) hospitals from eligibility for access payments and to remove unnecessary language on children’s hospitals.

• o DHS will expand the access payment pool to target 100% of the estimated cost of care following from proposed increases to the hospital assessment in the 2025-2027 Wisconsin biennial budget.

The Department is making the following changes to the sections in Wisconsin’s Medicaid Hospital Outpatient State Plan (Attachment 4.19-B).

• • Outpatient Access Payments:

• o DHS will modify §4250 Outpatient Access Payment to remove long term acute care (LTAC) hospitals from eligibility for access payments and to remove unnecessary language on children’s hospitals.

• o DHS will expand the access payment pool to target 100% of the estimated cost of care following from proposed increases to the hospital assessment in the 2025-2027 Wisconsin biennial budget.

These changes will be effective July 1, 2025. The changes to Medicaid and BadgerCare Plus are in total projected to result in increased annual expenditures of $201,953,582 all funds (AF), composed of $122,040,550 federal match (FED) and $79,913,032 state funds/general purpose revenue (GPR).

Copies of Changes Copies of Changes

Copies of the hospital Medicaid state plan amendment may be obtained free of charge by calling or writing:

Mail:

Attention: DHS State Plan Amendment (SPA) Coordinator Bureau of Benefits Policy

Division of Medicaid Services

P.O. Box 309

Madison, WI 53701-0309

Fax: [phone]

Attention: DHS State Plan Amendment (SPA) Coordinator

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

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 Room 350 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed change based on comments received.