Public Notices
Public Notice
Department of Health Services
(Medical Assistance Reimbursement for Coverage of Vaccine Administration)
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 and 49.688, Wisconsin Statutes. The Wisconsin Department of Health Services (the Department) 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.
Among the services provided, the state of Wisconsin covers legend and non-legend drugs and drug products and reimburses pharmacies for services provided to recipients of Medicaid and BadgerPlus. The Department proposes to make changes to coverage under these programs.
Proposed Change
The proposed change is as follows. The state plan lists the reimbursement rate for the administration of a vaccine as $3.00. In practice, this rate has been $3.31 for several years. The amount listed in the state plan will be increased to $3.31 to conform to current practice.
This change will be effective for dates of service on and after January 1, 2013. The correction to the stated rate for vaccine administration will have no actual effect, since the higher rate is what is currently paid. However, the change in rate results in a calculated change of an increase in annual expenditures in the amount of $52,500 all funds (AF), composed of $31,500 federal match (FED) and $21,000 state funds. The implementation date is the first day of the second quarter of federal fiscal year 2013 and is the first day of the third 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
Pam Appleby
Division of Health Care Access and Accountability
PO Box 309
Madison, WI 53701-0309
Phone
Pam Appleby
Division of Health Care Access and Accountability
(608) 261-9423
FAX
(608) 266-1096
Attention: Pam Appleby
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 (608) 266-1096. The e-mail address is
Pamela.Appleby@dhs.wisconsin.gov. 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.
Public Notice
Department of Health Services
(Medical Assistance Reimbursement for Coverage of Prescription Drugs Under Medicare Part D)
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 and 49.688, Wisconsin Statutes. The Wisconsin Department of Health Services (the Department) 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.
Among the services provided, the state of Wisconsin covers legend and non-legend drugs and drug products and reimburses pharmacies for services provided to recipients of Medicaid and BadgerPlus. The Department proposes to make changes to coverage under these programs.
Proposed Changes:
Effective for dates of service on and after January 1, 2013, benzodiazepines will become Medicare Part D-covered drugs. Claims for benzodiazepines for individuals covered under Medicare Part D and Medicaid should be submitted to Medicare Part D.
Effective for dates of service on and after January 1, 2013, barbiturates will become Medicare Part D-covered drugs when used for cancer, epilepsy, or chronic mental health disorder diagnoses. Claims for barbiturates for individuals with these diagnoses who are covered under Medicare Part D and Medicaid should be submitted to Medicare Part D.
This initiative is projected to result in decreased annual expenditures of $2.5 million all funds (AF), composed of $1.5 million federal match (FED) and $1 million state funds. The implementation date is the first day of the second quarter of federal fiscal year 2013 and is the first day of the third 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
Kim Reniero
Division of Health Care Access and Accountability
PO Box 309
Madison, WI 53701-0309
Phone
Kim Reniero
Division of Health Care Access and Accountability
(608) 267-7939
FAX
(608) 266-1096
Attention: Kim Reniero
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 (608) 266-
1096. The e-mail address is
KimP1.Reniero@dhs.wisconsin.gov. 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.
Public Notice
Department of Health Services
(Medical Assistance Reimbursement for Physicians 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 (the Department) administers 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.
