Special Enrollment Period for 2014 for Former BadgerCare Recipients
The federal Department of Health and Human Services (HHS) has announced a special enrollment period for those who lost BadgerCare coverage due to the eligibility changes implemented April 1, 2014.
The Department of Health Services estimates that this special enrollment period will affect the nearly 27,000 former BadgerCare recipients who have not signed up for coverage. They will now have until November 2 to enroll in an insurance plan on the Exchange.
DHS plans to send a letter to former BadgerCare recipients to notify them of the change.
For a link to DHS Outreach Information from 2013-14, click here.
Presumptive Eligibility (PE) for Hospitals
Under the Patient Protection and Affordable Care Act, hospitals may help patients who are potentially eligible for Medicaid apply for health coverage, and under new Medicaid presumptive eligibility regulations, hospitals can temporarily enroll patients in Medicaid coverage at the point of service with a few basic pieces of information such as income and household size.
Presumptive Eligibility – New Functionality and Training
The Department of Health Services is updating the process for hospitals to make presumptive eligibility determinations. DHS is rolling out a new web-based and new functionality beginning September 28. New training will be available. The details are provided in the ForwardHealth Update (2014-50), titled " Updated Process for Qualified Hospitals to Make Presumptive Eligibility Determinations for Individuals ,"
Hospital staff who make presumptive eligibility determinations are required to attend either an on-site training or watch the Webcast. Staff may choose the on-site training they will attend by registering online at: dhs.wisconsin.gov/forwardhealth/expressenrollment.htm. Registration is not required for the Webcast.
Chapter 12--ACCESS Handbook published:
Chapter 12 of the ACCESS Handbook, ACCESS for Partners and Providers, has been published at www.emhandbooks.wisconsin.gov/ah/ah.htm. Chapter 12 includes new information about the Express Enrollment process for making presumptive eligibility determinations in ACCESS. ForwardHealth Updates 2014-50 and 2014-51 include more information about these changes.
DHS Regional Enrollment Networks (RENs) - 2014
DHS announced the creation of Regional Enrollment Networks (RENs) to be comprised of various community partners, health care providers, income maintenance consortia, managed care entities, and other key stakeholders. These RENs will be developed at the local level and may be different from each other depending on the needs of the local region.
DHS Secretary’s Office communications staff will continue to be liaisons between the Regional Enrollment Networks (REN) and the Department. These staff can get answers to your BadgerCare plus policy questions, provide updates from the Department, and assist with State policy and procedure questions. Specific application or enrollment questions continue to be best addressed by helping clients contact their specific consortia.
Here is a link to an updated list of staff contacts and the areas to which they are assigned: http://dhs.wisconsin.gov/publications/P0/P00883.pdf.