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TMJ4 features Amy Mlot's testimony for personal care increases at JFC public hearing in Milwaukee

Ask Your State Legislator to Re-Invest Independent Assessment Funds into Personal Care

The state’s decision to cancel the independent assessment program for personal care means that there are currently unspent funds in the state budget that can and should be re-invested into the personal care program.

The Joint Finance Committee is wrapping up work on the 2017-19 state budget and will meet for one of the last times on September 5.

WPSA sent the attached memo to the Joint Finance Committee asking them to re-invest the $12 million in unspent funds from the Liberty HealthCare contract for the independent assessment into the personal care program.

What you can do to help: contact your state representative and state senator and ask them to make sure the unspent independent assessment funds are re-invested into the personal care program to help address the direct care workforce crisis and prevent agencies from going out of business. WPSA supports using these funds to reimburse personal care agencies for the cost of doing the assessments for personal care; building on the 2% per year increase to the personal care rate already included in the budget; or for the development of training programs.

Find out who represents you in the state capitol:
The first step in contacting your legislator is knowing who your legislator is. The easiest way to do this is the tool found on the Legislature’s home page. In the right-hand side of that page is a link that says Find My Legislators! Type your address in the box below that link to get the names of your state representative and senator.

Cancellation of the Personal Care Services Independent Assessment Program

The Wisconsin Department of Health Services (DHS) and Liberty Healthcare Corporation (Liberty) have mutually agreed to end their contract for personal care services assessments. DHS contracted with Liberty to conduct independent assessments and authorize the delivery of fee-for-service personal care services to members enrolled in Wisconsin Medicaid or BadgerCare Plus.
DHS will not be contracting with a new personal care independent assessment vendor as DHS is canceling the independent assessment program for fee-for-service members.
Effective August 1, 2017, ForwardHealth personal care services policy reverts to the policy that was in place prior to July 1, 2017.
During this transition, the highest priority for DHS is to ensure members receive the personal care services they need. ForwardHealth is mailing letters directly to eligible affected members.


Why Isn’t DHS Reimbursing Agencies for the New Medicaid Personal Care Rates?

As you know, the 2017-19 state budget bill included a 2% per year increase to the personal care rate. The state budget is a like a typical piece of legislation and must be signed into law by the Governor before it can take effect. The state budget bill has yet to reach the Governor's desk due to ongoing negotiations over transportation and K-12 education funding. So while the proposed budget says that the personal care rate should increase by 2% on July 1, 2017, the increase hasn’t taken effect yet because the budget has not become law. We will keep you updated as the state budget process continues.

Will The New Rates Be Retro-active Once the Budget is Passed?

Yes. However, you must bill the new rate in order to receive the adjustment. Staff from the Department of Health Services has confirmed to WPSA that once the budget is signed into law, Wisconsin Medicaid will do system-generated adjustments to correct the reimbursement amount to the new rate ($16.40) for all claims that have processed since July 1, 2017.

How Can I Make Sure that I Will Receive a Rate Adjustment?

As always, personal care agencies must bill their usual and customary charge and Medicaid will reimburse the lesser of your charge or the maximum reimbursement rate. Providers who bill at or in excess of $16.40 should get the retroactive rate adjustment to $16.40 after the rate becomes effective—even for past claims beginning July 1, 2017. Providers who use the current Medicaid reimbursement rate as their “usual and customary” rate ($16.08) likely will not get a retroactive rate adjustment because the rate billed is less than $16.40.

It is permissible to review your usual and customary charges and make adjustments.

Legislative Resources

Contacting Your Legislator

  • Find out who your legislators are by clicking HERE. Just type your address into the text box that appears at the top of the page that opens when you click the link.
  • Click HERE for a handout on how to contact your legislator
  • For an overview of how to contact your legislator click HERE
  • Click HERE for the brief "Do's and Don'ts" of contacting and communicating with your legislators

Brought to you by your WPSA Team

Also known as past President and current WPSA board member, Ginger Reimer demonstrates a "Can Do" photo message supporting our belief and vision that we can help make positive changes in our personal care industry by pitching in and collectively working together for the greater good of our clients, our staff, and the companies we work for!

A Message from Senator Tammy Baldwin

At our Winter Conference US Senator Tammy Baldwin sent along a special message.

Click the video below to listen.

To view a fullscreen version of the blog on click here