Public Comments on Personal Care Provider Travel Rate Cuts - Due 3/30/12

Agencies providing Medicaid personal care services receive reimbursement for the time it takes direct service workers to travel to peoples homes.

The Department of Health Services (DHS) plans to reduce the reimbursement for travel on April 1, 2012. The reduction in travel reimbursement rates could impact people receiving services because some agencies anticipate that they will have to stop serving some people.

DHS plans to implement the following:

• Pay urban providers half the current rate.
• Cap urban providers at 2 hours of travel time per consumer per day.
• Cap rural providers at 3 hours of travel time per consumer per day. The first two hours would be paid the full rate. The last hour would be paid half rate.
• Rural providers who travel less than 3 hours per person per day would be reimbursed the full rate.

DHS may consider changing their plans based on comments they receive by March 30th. DHS seeks input from individuals receiving personal care services about the impacts of the proposal travel reimbursement cuts. Comments can be submitted to the DHS Secretary at DennisG.Smith@dhs.wisconsin.gov andElizabeth.Scudder@dhs.wisconsin.gov.

Thanks to DAWN,an initiative of the Wisconsin Board for People with Developmental Disabilities (BPDD), for sharing this information.

See below for more details from the public notice sent out by DHS.

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*Changes to Personal Care Worker Travel Time Reimbursement Rates *

The State of Wisconsin reimburses providers for services provided toMedical Assistance recipients under the authority of Title XIX of theSocial Security Act and ss. 49.43to49.47WisconsinStatutes. This program, administered by the State's Department of HealthServices, is called Medical Assistance (MA) or Medicaid. In addition,Wisconsin has expanded this program to create the BadgerCare andBadgerCare Plus programs under the authority of Title XIX and Title XXIof the Social Security Act and ss.49.471,49.665, and49.67of theWisconsin Statutes. Federal statutes and regulations require that astate plan be developed that provides the methods and standards forreimbursement of covered services. A plan that describes thereimbursement system for the services (methods and standards forreimbursement) is now in effect.

The Wisconsin Department of Health Services is proposing to implement ahealthcare efficiency project related to personal care reimbursement.This project will not require that the Medicaid state plan be amended,but it will affect provider reimbursement rates. Changes to providerreimbursement rates will be reflected on the maximum allowable feeschedules, available online through the ForwardHealth Portal at:

https://www.forwardhealth.wi.gov/WIPortal/Max%20Fee%20Home/tabid/77/Default.aspx

The project would reduce the separate reimbursement rate paid topersonal care agencies for personal care worker travel time. For travelto recipients who do not reside in "rural" counties, the adjustedreimbursement rate for separate reimbursement of personal care workertravel will be at 50% of the personal care service rate. Thereimbursement rate for personal care services will not change.

*Proposed Change *

The proposed changes are to adjust reimbursement for personal careworker travel when reimbursed in addition to reimbursement for thepersonal care services. This change is projected to result in savings of$1.713 million all funds (AF) in the remaining quarter of federal fiscalyear 2012 (April 1, 2012 through June 30, 2012), composed of $676,000general purpose revenue (GPR) and $1.037 million federal match (FED). Infederal fiscal year 2013, the savings are projected to be $6.850 millionAF, composed of $2.758 GPR and $4.092 FED. The effective date of theproposal will be April 1, 2012.

*Copies of the Proposed Change: *

A copy of the proposed change may be obtained free of charge by callingor writing as follows:

*_Regular Mail_*

Elizabeth Scudder

Bureau of Benefits Management

Division of Health Care Access and Accountability

P.O. Box 309

Madison, WI 53701-0309

*_Phone

Elizabeth Scudder

(608) 267-9697

*FAX

(608) 266-1096

Attention: Elizabeth Scudder

*E-Mail

elizabeth.scudder@wisconsin.gov

A copy of the proposed change is available for review at the main officeof any county department of social services or human services.

*Written Comments: *

Written comments are welcome. Written comments on the proposed changesmay be sent by FAX, e-mail, or regular mail to the Department. The FAXnumber is (608) 266-1096. The e-mail address iselizabeth.scudder@wiconsin.govRegular mail can be sent tothe above address. All written comments will be reviewed and considered.

The written comments will be available for public review between thehours of 7:45 a.m. and 4:30 p.m. daily in Room 350 of the State OfficeBuilding, 1 West Wilson Street, Madison, Wisconsin. Revisions may bemade in the proposed changed methodology based comments received.