As part of the Methods of Implementation, providers are required to complete an independent financial audit. DHS has now made the Independent Reimbursement Form available for providers seeking reimbursement for eligible audit-related costs.
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The
2025 Direct Care Workforce Survey is now open for providers to report how they utilized workforce payments received since June 2024. Responses are due by Friday, March 21—completion is required for participation in the DCW Funding Initiative.
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On Tuesday evening, Governor Evers gave his Budget Address before a joint meeting of the State Legislature. Learn what’s ahead and how WHCA/WiCAL is advocating for our members.
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The Wisconsin Department of Health Services (DHS) will be releasing several system enhancements for the Preadmission Screen and Resident Review (PASRR) automated process in December 2024. DHS will release system enhancements that have a reimbursement impact in January 2025.
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The Wisconsin Department of Health Services (DHS) will release several system enhancements for the Preadmission Screen and Resident Review (PASRR) automated process in December 2024. DHS will release system enhancements that have a reimbursement impact in January 2025.
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Zimmet Healthcare Services Group (Zimmet) will be holding its annual skilled nursing reimbursement conference, July 16-18, 2024 at the Mohegan Sun Casino and Resort in Uncasville, Connecticut. Read more for details on July’s event, “Bon Voyage Reimbursement”
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Zimmet Healthcare Services Group (Zimmet) will be holding its annual skilled nursing reimbursement conference, July 16-18, 2024 at the Mohegan Sun Casino and Resort in Uncasville, Connecticut. Read more for details on July’s event, “Bon Voyage Reimbursement”
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Zimmet Healthcare Services Group (Zimmet) will be holding its annual skilled nursing reimbursement conference, July 16-18, 2024 at the Mohegan Sun Casino and Resort in Uncasville, Connecticut. Read more for details on July’s event, “Bon Voyage Reimbursement”
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The Department of Health Services (DHS) is reminding providers to submit their 2023 cost reports and corresponding documentation by the appropriate deadline. For providers with a fiscal year coinciding with the end of the calendar year, this
deadline will be April 30, 2024. Read More
Late last week, The Division of Medicaid Services (DMS) released a memo outlining the updated processes for contesting adjustments, requesting an administrative review, or resubmitting a cost report.
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Case mix index (CMI) resident rosters for the picture quarter ending June 30, 2023, (based on data available as of October 31, 2023) are now available on the
ForwardHealth Portal. These rosters contain Patient Driven Payment Model (PDPM) case mix index values for residents.
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The Veterans Administration (VA) recently posted
updated Veterans Care Agreements (VCAs) rates for participating skilled nursing facility (SNF) providers. This is great news for the profession because the
VCA SNF payment rates for short-stay SNF care have increased by approximately 50%, and long-stay veteran care payments have increased by approximately one-third. These rate increases apply retroactively for dates of service beginning October 1, 2023.
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Beginning
December 4, 2023, nursing home and hospital providers will be required to complete and submit all preadmission screen and resident review (PASRR) Level I screens through the secure ForwardHealth Portal. Please see below for detailed instructions and resources that are available to aide in the transition process. The training video referenced below demonstrates exactly how to access and complete the new automated screen.
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The state fiscal year (SFY) 2022 Nursing Home Methods of Implementation included a hold harmless provision in which facilities would be reimbursed for any rate reduction in excess of $2 per patient day. This resulted from the transition from Resource Utilization Groups (RUGs) to patient driven payment model (PDPM) acuity systems. This communication includes revisions to the quarter 1 (Q1) 2022 payments that were initially shared in November 2022, and new information for payments for Q2 2022.
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The 2023 Wisconsin Medicaid Nursing Facility Cost Report Template and corresponding Desk Review Checklist and Attestation are now available. Download them on the
Myers and Stauffer website or in the Help Resources section once logged into a provider specific Wisconsin Nursing Home Rate Setting (WINHRS) account.
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Earlier this year, the Department of Health Services (DHS) ended its contract with appraisal firm CBIZ. Until a new contract is in place, DHS will be inflating its facilities’ URC/DRC by 15% for the current cost report year.
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The Wisconsin Department of Health Services (DHS) has set interim rates for all nursing homes for state fiscal year 2024. For information about the components of your interim rates, please see the
Nursing Home Reimbursement webpage.
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The Division of Medicaid Services (DMS) has expressed their intent to begin reducing rates, by 25%, beginning on September 1
st for facilities who have not yet submitted the newly required checklist items.
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The Division of Medicaid Services (DMS) has expressed their intent to begin reducing rates, by 25%, beginning on September 1
st for facilities who have not yet submitted the newly required checklist items.
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Effective July 1, 2023, the Specialized Psychiatric Rehabilitative Services (SPRS) reimbursement rate increased from $23.39 to $24.19 per resident day. This supplemental payment is available to skilled nursing facilities that provide SPRS to residents determined to have a mental illness by a level II PASRR evaluation. This updated rate is for all Medicaid-certified nursing homes and professionals who work in the Preadmission Screening and Resident Review (PASRR) process.
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The Wisconsin Department of Health Services (DHS) is announcing changes to the patient driven payment model prospective payment system case mix index (PDPM PPS CMI). This implements the parity adjustments from CMS. The parity adjustment is tied to
CMS final rule 1765 and results in reduced CMIs for direct care. DHS has increased the nursing services base and other direct care supplies and services base to offset this reduction in CMIs.
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The Wisconsin Department of Health Services (DHS) is renewing the Family Care and Family Care Partnership waivers. A waiver is a special set of rules that allows for Medicaid programs like Family Care. The waivers must be renewed every five years. DHS is asking that providers complete a
survey to help make Family Care and Family Care Partnership better between 2025 and 2030.
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The Wisconsin Department of Health Services (DHS) is renewing the Family Care and Family Care Partnership waivers. A waiver is a special set of rules that allows for Medicaid programs like Family Care. The waivers must be renewed every five years. DHS is asking that providers complete a
survey to help make Family Care and Family Care Partnership better between 2025 and 2030.
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The Wisconsin Department of Health Services (DHS) is renewing the Family Care and Family Care Partnership waivers. A waiver is a special set of rules that allows for Medicaid programs like Family Care. The waivers must be renewed every five years. DHS is asking that providers complete a
survey to help make Family Care and Family Care Partnership better between 2025 and 2030.
Read More
The Wisconsin Department of Health Services (DHS) is renewing the Family Care and Family Care Partnership waivers. A waiver is a special set of rules that allows for Medicaid programs like Family Care. The waivers must be renewed every five years. DHS is asking that providers complete a
survey to help make Family Care and Family Care Partnership better between 2025 and 2030.
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The budget bill now heads to both chambers of the State Legislature, where few changes are expected on the floor. The Legislature is expected to be on the floor next week to take up the budget.
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The budget bill now heads to both chambers of the State Legislature, where few changes are expected on the floor. The Legislature is expected to be on the floor next week to take up the budget.
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Late in the day on Thursday, June 15, the Wisconsin State Legislature's Joint Finance Committee voted on state budget provisions related to health services, including long-term care funding. WHCA/WiCAL is pleased to report that the Committee included important increases for both skilled nursing Medicaid reimbursement and Family Care funding.
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The Centers for Medicare & Medicaid Services (CMS) on Tuesday issued the
proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2024 update. AHCA CEO Mark Parkinson and team will review key details of the proposed rule during a
member webinar this
Friday, April 7 at 2 PM Eastern.
Registration is required. Read More
All Adult Family Homes, Community Based Residential Facilities and Residential Care Apartment Complexes that participate in the Family Care program and that have received Direct Care Workforce Fund distributions in June 2022 and December 2022 should have received the request below that originated from the Department of Health Services, Division of Medicaid Services. We know that you are very busy with so many other priorities but it is important to note that as a recipient of Workforce Funds, completion and return of this survey
is mandatory by March 24th. Read More
All Adult Family Homes, Community Based Residential Facilities and Residential Care Apartment Complexes that participate in the Family Care program and that have received Direct Care Workforce Fund distributions in June 2022 and December 2022 should have received the request below that originated from the Department of Health Services, Division of Medicaid Services. We know that you are very busy with so many other priorities but it is important to note that as a recipient of Workforce Funds, completion and return of this survey
is mandatory by March 24th. Read More
All Adult Family Homes, Community Based Residential Facilities and Residential Care Apartment Complexes that participate in the Family Care program and that have received Direct Care Workforce Fund distributions in June 2022 and December 2022 should have received the request below that originated from the Department of Health Services, Division of Medicaid Services. We know that you are very busy with so many other priorities but it is important to note that as a recipient of Workforce Funds, completion and return of this survey
is mandatory by March 24th. Read More
All Adult Family Homes, Community Based Residential Facilities and Residential Care Apartment Complexes that participate in the Family Care program and that have received Direct Care Workforce Fund distributions in June 2022 and December 2022 should have received the request below that originated from the Department of Health Services, Division of Medicaid Services. We know that you are very busy with so many other priorities but it is important to note that as a recipient of Workforce Funds, completion and return of this survey
is mandatory by March 24th. Read More
The Wisconsin Department of Health Services (DHS) is launching the second round of Home and Community-Based Services (HCBS)
Grants Supporting Quality and Innovation, funded through the American Rescue Plan Act (ARPA). The grants will range from $25,000 to $1 million to enact innovative changes that will benefit participants, families, and the long-term care workforce in Wisconsin.
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On January 30, the Biden Administration
announced its plans to end the Public Health Emergency (PHE). This administration guidance meets the Administration’s promise of 60 days’ notice of the end of the PHE. Based on the guidance, the PHE will end on May 11, 2023.
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On January 30, the Biden Administration
announced its plans to end the Public Health Emergency (PHE). This administration guidance meets the Administration’s promise of 60 days’ notice of the end of the PHE. Based on the guidance, the PHE will end on May 11, 2023.
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Health Resources and Services Administration (HRSA) released two important updates related to the Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments HRSA began distributing in November 2021 and throughout 2022.
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Health Resources and Services Administration (HRSA) began transmitting emails to providers who, based on Provider Relief Fund (PRF) Reporting Period 1 submissions, will be receiving a Repayment Request Notice via the U.S. Postal Service (USPS). In guidance to AHCA/NCAL, HRSA noted:
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Nursing home providers have an updated NEMT rate and definition of a “trip” – please see details below provided by The Department of Health Services (DHS).
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Due to the move to the patient driven payment model (PDPM) in January of this year, the Department of Health Services (DHS) has implemented a hold harmless. Any facility experiencing a loss greater than $2 per patient day, will receive a payment to keep them at no more than $2 per patient day.
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Effective July 1, 2022, the Specialized Psychiatric Rehabilitative Services (SPRS) reimbursement rate increased from $9.00 to $23.39 per resident day. This supplemental payment is available to skilled nursing facilities that provide SPRS to residents determined to have a mental illness by a level II PASRR evaluation.
Read More
Effective July 1, 2022, the Specialized Psychiatric Rehabilitative Services (SPRS) reimbursement rate increased from $9.00 to $23.39 per resident day. This supplemental payment is available to skilled nursing facilities that provide SPRS to residents determined to have a mental illness by a level II PASRR evaluation.
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The Wisconsin Department of Health Services (DHS) American Rescue Plan Act (ARPA) Adult HCBS Minimum Fee Schedule Provider Cost Survey is now available. You’re invited...
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The Wisconsin Department of Health Services (DHS) American Rescue Plan Act (ARPA) Adult HCBS Minimum Fee Schedule Provider Cost Survey is now available. You’re invited...
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The Wisconsin Department of Health Services (DHS)
American Rescue Plan Act (ARPA) Adult HCBS
Minimum Fee Schedule Provider Cost Survey is
now available. You’re invited to participate. Read More
The Wisconsin Department of Health Services (DHS) will launch its
American Rescue Plan Act (ARPA) Adult HCBS
Minimum Fee Schedule Provider Cost Survey in
early October 2022. You’re invited to participate. DHS will use survey data to develop a minimum fee schedule for select home and community-based services (HCBS) in the Family Care and Family Care Partnership programs.
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The Wisconsin Department of Health Services (DHS) will launch its
American Rescue Plan Act (ARPA) Adult HCBS
Minimum Fee Schedule Provider Cost Survey in
early October 2022. You’re invited to participate. DHS will use survey data to develop a minimum fee schedule for select home and community-based services (HCBS) in the Family Care and Family Care Partnership programs.
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Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed. To date, more than $8 billion has been distributed through ARP Rural Payments and 99% of applications have been processed. Providers who received Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate between January 1, 2021, and June 30, 2021, are required to report in RP3.
The deadline for providers to submit a report is September 30, 2022, at 11:59 PM ET. Read More
The Wisconsin Department of Health Services (DHS) will launch its
American Rescue Plan Act (ARPA) Adult HCBS
Minimum Fee Schedule Provider Cost Survey in
early October 2022. You’re invited to participate. DHS will use survey data to develop a minimum fee schedule for select home and community-based services (HCBS) in the Family Care and Family Care Partnership programs.
Read More
The Wisconsin Department of Health Services (DHS) will launch its
American Rescue Plan Act (ARPA) Adult HCBS
Minimum Fee Schedule Provider Cost Survey in
early October 2022. You’re invited to participate. DHS will use survey data to develop a minimum fee schedule for select home and community-based services (HCBS) in the Family Care and Family Care Partnership programs.
Read More
Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed. To date, more than $8 billion has been distributed through ARP Rural Payments and 99% of applications have been processed. Providers who received Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate between January 1, 2021, and June 30, 2021, are required to report in RP3.
The deadline for providers to submit a report is September 30, 2022, at 11:59 PM ET. Read More
On Wednesday morning, personnel from the Division of Medicaid Services (DMS) held the final public provider Methods meeting finalizing the rate setting formula for SFY23. The final formula includes historic rate increases in the Support Services cost center as well as strong increases in Direct Care - Nursing.
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On Wednesday morning, personnel from the Division of Medicaid Services (DMS) held the final public provider Methods meeting finalizing the rate setting formula for SFY23. The final formula includes historic rate increases in the Support Services cost center as well as strong increases in Direct Care - Nursing.
Read More
Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed. To date, more than $8 billion has been distributed through ARP Rural Payments and 99% of applications have been processed. Providers who received Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate between January 1, 2021, and June 30, 2021, are required to report in RP3.
The deadline for providers to submit a report is September 30, 2022, at 11:59 PM ET. Read More
Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed. To date, more than $8 billion has been distributed through ARP Rural Payments and 99% of applications have been processed. Providers who received Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate between January 1, 2021, and June 30, 2021, are required to report in RP3.
The deadline for providers to submit a report is September 30, 2022, at 11:59 PM ET. Read More
Recently, Department of Health Services (DHS) announced a new grant opportunity that will be open to Home and Community Based Services (HCBS) providers. There will be $30 million of ARPA funding available through two to three rounds of the grant.
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Recently, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 (10/1/22-9/30/23) update.
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On Friday, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 (10/1/22-9/30/23) update.
Read More
On Friday, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 (10/1/22-9/30/23) update.
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The Centers for Medicare & Medicaid Services (CMS) has released its Unified Post-Acute Care (UPAC) Prototype Payment System
Report to Congress. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) mandated a UPAC Prototype Report be developed by MedPAC and CMS for Congress, but Congress is not required to act upon the report.
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Last Friday, the Division of Medicaid Services (DMS) within the Department of Health Services (DHS) held it’s first public
Methods of Implementation meeting for SFY23 via Zoom.
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Last Friday, the Division of Medicaid Services (DMS) within the Department of Health Services (DHS) held it’s first public
Methods of Implementation meeting for SFY23 via Zoom.
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On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
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The first Public Provider Methods meeting is scheduled for next Friday, June 10 from 1:00-3:00 p.m.
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On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
On Monday, April 11th, CMS released the proposed rule,
FY 2023 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1765). Due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million.
Read More
A reminder that AHCA/NCAL will host a
webinar for all members on
Thursday, April 21 at 2:00 PM CST to provide tips for drafting and submitting your comments on the
FY 2023 SNF Proposed Payment Rule. The webinar will be recorded, and all registrants will receive an email when the recording is ready.
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On Monday, the Centers for Medicare & Medicaid Services (CMS)
issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 update.
Read More
On Monday, the Centers for Medicare & Medicaid Services (CMS)
issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 update.
Read More
The Division of Quality Assurance (DQA) is hosting the quarterly Resident Assessment Instrument (RAI)/Minimum Data Set (MDS) Educational Forum on Wednesday, March 16, 2022, from 1-2 p.m. The MDS Education Coordinator will address current MDS 3.0 topics relevant to nursing home providers.
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Six months into the 2021-23 State Budget, the Department of Health Services is projecting the Medicaid fund to finish the biennium with a surplus of $184.9 million in general purpose revenue, which is an increase from September's projection of a $39.4 million surplus.
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Due to recent rate cuts in the Family Care program, WHCA/WiCAL is currently conducting a survey to demonstrate the severity of the rate-setting process and have accurate data to present in advocacy efforts. This data is critical to ensure we have up-to-date figures on Family Care rate increases and decreases. Responses are due by
Friday, March 5, 2021. Read More
The Division of Quality Assurance is hosting the quarterly Resident Assessment Instrument (RAI)/Minimum Data Set (MDS) Educational Forum on Wednesday, October 28, 2020, from 1-2 p.m. The MDS Education Coordinator will address current MDS 3.0 topics relevant to nursing home providers.
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