Public Notices

public_notices Wisconsin Administrative Register No. 682, 10/14/2012

Public Notices

Department of Health Services

(Medical Assistance Reimbursement for Health Home Services)

The state of Wisconsin reimburses providers for services provided to low-income persons under the authority of Title XIX of the Social Security Act and sections 49.43 to 49.47, Wisconsin Statutes. The Wisconsin Department of Health Services administers this program, which is called Medical Assistance 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 chapters 49.43 to 49.47 of Wisconsin Statutes. Together the Medical Assistance and BadgerCare Plus programs are referred to as ForwardHealth.

Section 1945 of the Social Security Act provides authority for a State, at its option as a State plan amendment, to provide health home services to individuals with chronic conditions. This authority allows states to pay a designated provider, a team of health care professionals operating with such a provider, or a health team as the individual's health home for purposes of providing the individual with health home services. Wisconsin has elected to use the designated provider approach for this benefit. Health home services will be available to individuals with HIV infection, starting October 1, 2012. A previous public notice describing this and other health home initiatives was published on November 30, 2011.

The health home model of care is a comprehensive approach to care management, integrating primary care, behavioral health, acute and long-term care. The patient's primary care physician and others involved in the patient's care collaborate on the development of a single plan of care. The patient is central to this care management approach. The primary goals are to improve the patient's experience of care, health outcomes and reduce costs.

Wisconsin Medicaid and BadgerCare Plus members with HIV infection and at least (or is at risk of developing) one other co-occurring chronic condition will be eligible for these services. The designated providers for these services are AIDS Service Organizations that are funded by Wisconsin Department of Health Services to provide life care services to individuals with HIV infection. The Department will pilot the benefit in the counties of Milwaukee, Kenosha, Dane and Brown.

This initiative is projected to result in increased annual expenditures of $727,982 all funds (AF), composed of $655,184 of federal match (FED) and $72,798 of state funds, which are from existing Michael Johnson state grant funds. The start date, October 1, 2012, is the first day of federal fiscal year 2013 and is the first day of the second quarter of state fiscal year 2013.

Written Comments and Copies of the Proposed Change

A copy of the proposed change may be obtained free of charge at your local county agency or by calling or writing as follows:

Regular Mail

Eileen McRae
Division of Health Care Access and Accountability

PO Box 309

Madison, WI 53701-0309

Phone

Eileen McRae

Division of Health Care Access and Accountability

[phone]

FAX

[phone]

Attention: Eileen McRae

E-Mail

[e-mail]

A copy of the proposed change is 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 change may be sent by FAX, e-mail, or regular mail to the Division of Health Care Access and Accountability. The FAX number is [phone]. The e-mail address is [e-mail]. Regular mail can be sent to the above address. All written comments will be reviewed and considered.

All written comments received 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 based on comments received.