Public Notices
Health Services
Annual Adjustment to Fees
That May be Charged by a Health Care Provider for
Providing Copies of a Patient's Health Care Records
Statutory Authority
Pursuant to Wis. Stat. s.
146.83 (3f) (c) 2., each July 1, beginning on July 1, 2012, the Department of Health Services is required to adjust, by the percentage difference between the consumer price index for the 12-month period ending on December 31 of the preceding year and the consumer price index for the 12-month period ending on December 31 of the year before the preceding year, the dollar amounts specified under Wis. Stat. s.
146.83 (3f) (b) that a health care provider may charge for providing copies of a patient's health care records.
Under the methods prescribed in Wis. Stat. s.
146.83 (3f) (c) 2., the adjusted dollar amounts that a health care provider may charge for providing copies of a patient's health care records are as follows:
Schedule of Health Care Provider Records Fees
July 1, 2014 – June 30, 2015
Health Services
Wisconsin Department of Health Services
(Public Forum Regarding BadgerCare Plus Demonstration Project Waiver)
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 Chapter
49 of the 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 BadgerCare Plus program under the authority of Title XIX and Title XXI of the Social Security Act and Chapter
49 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 now in effect.
Section 1115 of the Social Security Act provides the federal Secretary of Health and Human Services broad authority to authorize Research & Demonstration Projects, which are experimental, pilot, or demonstration projects likely to assist in promoting the objectives of the Medicaid statute. Flexibility under §1115 is sufficiently broad to allow states to test substantially new ideas of policy merit. Wisconsin sought and received approval of a demonstration project waiver from the Centers for Medicare and Medicaid Services (CMS) under this federal authority. CMS is an agency within the U.S. Department of Health and Human Services (DHHS).
The waiver allows Wisconsin to provide health care coverage through BadgerCare Plus to all childless adults between ages 19 and 64 and who have incomes that do not exceed 100% of the federal poverty level (FPL), beginning April 1, 2014. The 2013-15 biennial budget had originally planned for the program changes to go into effect on January 1, 2014; however, due to challenges with the federal Health Insurance Marketplace, Governor Walker and the Wisconsin Legislature delayed these changes by 90 days to April 1, 2014. For additional details please see:
The Wisconsin BadgerCare Reform demonstration provides state plan benefits other than family planning services and tuberculosis-related services to childless adults who have family incomes up to 95 percent of the Federal Poverty Level (FPL) (effectively 100 percent of the FPL considering a disregard of 5 percent of income), and permits the state to charge premiums to adults who are only eligible for Medicaid through the Transitional Medical Assistance eligibility group (hereinafter referred to as “TMA Adults") with incomes above 133 percent of the FPL starting from the first day of enrollment and to TMA Adults from 100-133 percent of the FPL after the first 6 calendar months of TMA coverage.
The demonstration will allow the state to provide health care coverage for the childless adult population at or below an effective income of 100 percent of the FPL with a focus on improving health outcomes, reducing unnecessary services, and improving the cost-effectiveness of Medicaid services. Additionally, the demonstration will enable the state to test the impact of providing TMA to individuals who are paying a premium that aligns with the insurance affordability program in the Marketplace based upon their household income when compared to the FPL.
The state's goals for the program are to demonstrate whether the program will:
• Ensure every Wisconsin resident has access to affordable health insurance and reduce the state's uninsured rate.
• Provide a standard set of comprehensive benefits for low income individuals that will lead to improved healthcare outcomes.
• Create a program that is sustainable so Wisconsin's healthcare safety net is available to those who need it most.
In accordance with federal law, Section
431.420(c) of 42 CFR, the Department must conduct a public forum within 6 months after the implementation date of a §1115 demonstration project, and annually thereafter. At the public forum, the Department is to solicit comments on the progress of the demonstration project, and allow members of the public the opportunity to provide comments. The Department is to include a summary of the forum in the quarterly report to CMS associated with the quarter in which the forum was held, as well as in its annual report to CMS.
This notice serves to meet these federal requirements and to notify the public that the State of Wisconsin implemented a new BadgerCare Plus Demonstration Project Waiver on April 1, 2014. The new BadgerCare Plus Demonstration Project Waiver replaces two expired waivers: the BadgerCare and BadgerCare Plus for Childless Adults Section 1115 Demonstrations, as amended by the Medicaid 2014 Demonstration Project Waiver on July 1, 2012.
The following public hearing will be conducted:
Thursday, July 10
3:00 to 5:00 p.m.
Greater Philadelphia Church of God in Christ
2947 N. Dr. Martin Luther King Drive
Milwaukee, WI 53212
Through the BadgerCare Reform waiver, Wisconsin is providing full Medicaid benefits through the Standard Plan, including enhanced mental health benefits, substance abuse treatment and prevention benefits, to all adults in poverty who were enrolled in Medicaid and BadgerCare Plus. Previously, this level of coverage had not been available to childless adults.
Accessibility
English
DHS is an equal opportunity employer and service provider. If you need accommodations because of a disability or need an interpreter or translator, or if you need this material in another language or in an alternate format, you may request assistance to participate by contacting Al Matano at (608)267-6848. You must make your request at least 7 days before the activity.
Spanish
DHS es una agencia que ofrece igualdad en las oportunidades de empleo y servicios. Si necesita algún tipo de acomodaciones debido a incapacidad o si necesita un interprete, traductor o esta información en su propio idioma o en un formato alterno, usted puede pedir asistencia para participar en los programas comunicándose con Al Matano al número (608)267-6848. Debe someter su petición por lo menos 7 días de antes de la actividad.
Hmong
DHS yog ib tus tswv hauj lwm thiab yog ib qhov chaw pab cuam uas muab vaj huam sib luag rau sawv daws. Yog koj xav tau kev pab vim muaj mob xiam oob qhab los yog xav tau ib tus neeg pab txhais lus los yog txhais ntaub ntawv, los yog koj xav tau cov ntaub ntawv no ua lwm hom lus los yog lwm hom ntawv, koj yuav tau thov kev pab uas yog hu rau Al Matano ntawm (608)267-6848. Koj yuav tsum thov qhov kev pab yam tsawg kawg 7 hnub ua ntej qhov hauj lwm ntawd.
COPIES OF DEMONSTRATION PROJECT WAIVER
Copies of Waiver Documents
Regular Mail
Al Matano
Division of Health Care Access and Accountability
P.O. Box 309
Madison, WI 53707-0309
Phone
Al Matano
(608)267-6848
FAX
(608)261-7792
E-Mail
WRITTEN COMMENTS
Written comments are welcome and will be accepted through July 30, 2014. Written comments on the progress of the waiver to date 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
BCDemonstrationWaiver@dhs.wisconsin.gov. Comments can be made on the web site at:
Regular mail can be sent to the above address.
Public comments will be considered to evaluate the progress of the demonstration project. A summary of the comments received will be included in the Department's quarterly report to CMS, and will be available on the department's web site at the address listed above.
