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.

The purpose of the report is to calculate additional payments due to providers that had per diem payments under the patient driven payment model (PDPM) less than they would have been under the Resource Utilization Groups (RUGS) system. Federal data as of July 31, 2022, was used for this report.

Providers eligible for a payment had an average daily decrease of more than $2 per patient day, per the hold harmless provision, State Fiscal Year 2022 Methods Section 2.60.

• If your facility is eligible for payment, you will receive the report under the “Hold Harmless Report” event on your Wisconsin Nursing Home Rate Setting (WINHRS) stat log for fiscal year ending 2020.
• If your facility is not eligible for payment, you may request a copy of your report by emailing WINHRSHelpDesk@mslc.com. Include your POP ID in the request.

The Wisconsin Department of Health Services will issue payments to facilities for services rendered by fee-for-service providers, as per the facility’s report. MCOs are required to submit payments to facilities for services rendered by their network providers. MCOs have been provided a report detailing how much they owe each facility.

If you believe a calculation has been made in error, contact your assigned auditor before December 2, 2022. We will issue payments no earlier than December 5, 2022. Payments will be processed via ForwardHealth and will show up in your facility’s remittance advice.