Help DHS Establish Minimum Provider Reimbursement Rates

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. Minimum rates will be set for:

• Adult family homes (AFHs)
• Residential care apartment complexes (RCACs)
• Community-based residential facilities (CBRFs)
• Supportive home care services, including supported independent living (SIL) services
• Personal care services

Live-in caregivers, owner-occupied AFHs with 1-2 beds, and any providers who use their Social Security Number (SSN) as their provider ID for billing purposes are not being asked to complete the survey. DHS will conduct focus groups with owner-occupied AFHs with 1-2 beds to collect additional information on their cost structure.

Once the new minimum fee schedule is implemented:

• DHS will require that Family Care and Family Care Partnership managed care organizations (MCOs) pay providers no less than the minimum fee schedule
• MCOs and providers can still negotiate higher rates based on member needs

Additional details:

• Providers are only being asked to complete one survey for their organization
• You will have 31 days to complete the survey after it is released in early October
• Instructions, questions & answers (Q&A), and other training resources will be available on the DHS website
• Please email questions about the survey directly to our survey partner, Milliman, Inc., at WIHCBS@milliman.com

Look for an announcement of the survey’s release in early October. In the meantime, please visit the DHS website for more information about the ARPA Medicaid HCBS Rate Reform Initiative.

We thank you in advance for your participation in this highly important survey!

Sincerely,
The DHS and Milliman, Inc. ARPA Adult HCBS Minimum Fee Schedule Team