ForwardHealth Community Partners
Updated Health Care Renewal Process
This email is to let partners know that some members can expect to have a change in their renewal process. Starting May 13, 2017, the renewal process for BadgerCare Plus, Family Planning Only Services, and Medicaid for the elderly, blind, or disabled will be updated to use information in a member’s case file, along with information available through electronic data exchanges, when possible, to renew a member’s health care benefits without requiring additional information or action from the member. The renewal process will begin statewide on May 13, 2017, for health care renewals due on June 30, 2017.
Because the new process is based on whether information is available from data exchanges and whether that information can be used to validate information on a member’s case, there is no action a member, partner, or provider can take to make a case qualify for this updated renewal process.
This renewal process applies to health care benefits only. This process does not apply to FoodShare, Caretaker Supplement, or Wisconsin Shares Child Care.
How the Renewal Process Works
If information is available to renew a member’s health care benefits, and a renewal was able to be completed using this information, the member will receive a notice indicating his or her benefits have been renewed. For most members, the notice will include an attached summary of the information that was used to determine their eligibility. The member must review the summary and report if any of the information is incorrect within 30 days. If there are no changes, the member does not need to sign or return anything. View an example notice that a member will receive when his or her benefits have been renewed.
Members who are only receiving Group A Home and Community-Based Waivers or Medicare Savings Programs Qualified Medicare Beneficiary (QMB) benefits based on their eligibility for Supplemental Security Income (SSI) will be sent a different notice indicating their benefits have been renewed because they continue to qualify for SSI. They will not have to review a summary. View an example notice that a member will receive when his or her Group A Waivers or QMB benefits have been renewed.
If information is not available to renew a member’s health care benefits, the member will receive a renewal notice and case summary, as they do today. The member can renew his or her health care benefits by phone, by mail, online, or in person. If the member renews his or her benefits by mail, the member can make any necessary updates to the case summary and send it back to the agency address listed on the first page of the renewal notice. View an example notice that a member will receive when he or she needs to renew his or her benefits.
A member’s benefits will not be terminated or reduced based solely on the information that is obtained from a data exchange. If a member’s case is evaluated through the renewal process using data exchanges and it is determined that the member’s benefits should be terminated or reduced, the member will receive a renewal notice and case summary. This renewal reminder will be sent 45 days prior to the renewal due date, as it is today. The member will need to renew his or her health care benefits by phone, by mail, online, or in person by the renewal due date.
From February through May 2017, the Department of Health Services (DHS) conducted a pilot of the renewal process in the Central Consortium (this includes Oneida, Langlade, Marathon, and Portage counties). Throughout the pilot, approximately 15 percent of health care cases were renewed through the renewal process. Once the process goes statewide, DHS expects modest increases in the percentage of cases that are renewed using this renewal process.
If you have questions about the updated renewal process, email DHS ForwardHealth Partners.
Subject: Advocacy Resources on the American Health Care Act and Potential Cuts to Medicaid
Source: Survival Coalition
Two Survival Coalition members have developed advocacy resources on the American Health Care Act and potential cuts to Medicaid.
· Wisconsin Ideas for Sustaining Medicaid with Common Sense Reforms
· Why High Risk Insurance Pools Didn’t Work for Wisconsin