Effective August 1, 2021, this amendment corrects an error regarding the required frequency of contacts between targeted case managers and beneficiaries.

Effective January 1, 2021, this amendment decreases select Durable Medical Equipment (DME)/ Disposable Medical Supplies (DMS) codes from 85 percent to 80 percent of the current Medicare rates while clarifying payment for DME/DMS where no Medicare fee exists.

Effective January 1, 2020, this amendment increases various inpatient hospital "price per point" rates, generally by 3.1 percent. 

Effective January 1, 2021, this amendment increases nursing facility and intermediate care facility for individuals with intellectual disabilities per diem rates by 3.1 percent.

Effective February 20, 2021, this amendment is to amend the provisions governing laboratory and radiology services in order to ensure that the existing language reflects current practices, remove coding and billing instructions and other extraneous information.

Effective April 1, 2021, this amendment adds Licensed Marriage and Family Therapists to the approved Other Licensed Practitioners (OLP) in the state plan, including as recognized licensed OLP Dually Licensed Practitioners. In addition, this amendment adds a reimbursement methodology for Licensed Marriage and Family Therapist practitioner and updates the existing OLP benefit pages.

Effective the day after the Public Health Emergency (PHE) ends, this amendment revises the providers that can order home health services. In addition to physicians, the amendment allows nurse practitioners, clinical nurse specialists, or physician assistants, working in accordance with State law, to order home health services to comply with federal regulation. 

Effective January 1, 2021, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. CMS notes that Wisconsin covered all required MAT services to treat Opioid Use Disorder (OUD) elsewhere in the state plan prior to the January 1, 2021 effective date of the SPA.

Effective July 1, 2021, this amendment establishes an ambulance transportation quality assurance fee program that will provide an add-on to fee-for-service emergency ambulance rates for non-public and non-federal emergency ambulance transportation providers. The add-on rate will be funded solely from assessments to the same providers. This assessment and add-on rate will not apply to any unit of government as defined in 42 CFR Sec 13 433.50, including federally recognized Indian tribes.

Effective February 24, 2021, this amendment adds payment for tribal health clinics including an alternate payment method for tribal Federally Qualified Health Center (FQHCs) equal to OMB all-inclusive rate.