Medicaid

Division of Medicaid Services Hosts Public Provider Methods Meeting

This morning, the Division of Medicaid Services (DMS) hosted its Public Provider Meeting for Nursing Home Rates. This meeting is held yearly to update providers on new rate information, uses of available funding and any other changes to the Methods of Implementation for Wisconsin Nursing Home Payment Rates. Read More

ICYMI: CMS Finalizes Additional SNF Transparency Requirements Regarding Ownership, Disclosable Parties, and Public Reporting

On November 15, the Centers for Medicare and Medicaid Services (CMS) issued a display copy of a final rule, titled Medicare and Medicaid Programs: Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers' and Suppliers' Disclosure of Private Equity Companies and Real Estate Investment Trusts. Read More

DHS Conducting Survey of Nursing Home Residents in Partnership with NCI

A memo has been sent to Wisconsin skilled nursing facilities regarding an upcoming survey that the Department of Health Services (DHS) will be conducting in partnership with several organizations. The survey will be in-person, of nursing home residents whose payer is Medicaid or other Medicaid programs. The participants will be randomly selected and notified. For more information, please see DHS’s memo here. Read More

Nursing Home Appraisals – Input Needed

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. Read More

New Specialized Psychiatric Rehabilitative Services Reimbursement Rate

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. Read More

Family Care Survey Due August 1

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

Family Care Survey Due August 1

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

Family Care Survey Due August 1

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

Family Care Survey Open for Providers

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

CMS Final Rule Removes COVID-19 Testing and Staff Vaccination Requirements

On May 31, 2023, the Centers for Medicare and Medicaid Services (CMS) announced a final rule, “Medicare and Medicaid Programs; Policy and Regulatory Changes to the Omnibus COVID-19 Health Care Staff Vaccination Requirements; Additional Policy and Regulatory Changes to the Requirements for Long-Term Care (LTC) Facilities and Intermediate Care Facilities for Individuals With Intellectual Disabilities (ICFs-IID) to Provide COVID-19 Vaccine Education and Offer Vaccinations to Residents, Clients, and Staff; Policy and Regulatory Changes to the Long Term Care Facility COVID-19 Testing Requirements.” Read More

New Consequences For Nursing Homes in Special Focus Facility Program

The Special Focus Facility (“SFF”) Program is an ongoing initiative in which the Centers for Medicare and Medicaid Services (CMS) selects a set number of nursing homes in each state as a Special Focus Facility. CMS generates a list of poor performing facilities in a state from recent survey results and shares that list with that state’s Survey Agency (“SA”) so that the SA can recommend which nursing homes should be made SFFs. Read More

New Consequences For Nursing Homes in Special Focus Facility Program

The Special Focus Facility (“SFF”) Program is an ongoing initiative in which the Centers for Medicare and Medicaid Services (CMS) selects a set number of nursing homes in each state as a Special Focus Facility. CMS generates a list of poor performing facilities in a state from recent survey results and shares that list with that state’s Survey Agency (“SA”) so that the SA can recommend which nursing homes should be made SFFs. Read More

CMS Reverses Position on Employee Retention Tax Credit

Originally, CMS had informally instructed State Medicaid Agencies to offset Employee Retention Tax Credit (ERC) against cost. This position would have resulted in reductions in Medicaid rates. Several states already had begun issuing Medicaid rate letters. This guidance was completely different from CMS’ PPP and PRF guidance – those funds were to be disregarded for Medicaid rate setting. Read More

What Do I Need to Know? CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency

As part of the Centers for Medicare & Medicaid Services’ (CMS) ongoing efforts to provide up-to-date information to prepare for the end of the Public Health Emergency (PHE) for COVID-19, which is expected on May, 11, 2023, we are providing a new overview fact sheet on CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency.  COVID-19 efforts have been a significant priority for the Biden-Harris Administration, and with the use of whole-of-government approach, the country is in a better place. Over the next several months, we will work to ensure a smooth transition back to normal operations. Read More

What Do I Need to Know? CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency

As part of the Centers for Medicare & Medicaid Services’ (CMS) ongoing efforts to provide up-to-date information to prepare for the end of the Public Health Emergency (PHE) for COVID-19, which is expected on May, 11, 2023, we are providing a new overview fact sheet on CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency.  COVID-19 efforts have been a significant priority for the Biden-Harris Administration, and with the use of whole-of-government approach, the country is in a better place. Over the next several months, we will work to ensure a smooth transition back to normal operations. Read More