ForwardHealth may require providers who offer a variety of services to complete a separate Medicaid enrollment application for each specified service and provider type. The number of Medicaid enrollments allowed or required per location is based on licensure, registration, and certification by a state agency, federal agency, or an accreditation association identified in the Wisconsin Administrative Code. Providers may call Provider Services with questions.

If a Medicaid-enrolled provider begins offering a new service after their initial enrollment, it is recommend that they call Provider Services to inquire whether they are required to complete another enrollment application.

The adult long-term care (LTC) waiver providers listed below must complete enrollment and receive a unique Medicaid ID for each physical service location. The Wisconsin Department of Health Services (DHS) requires this to track compliance with the Home and Community-Based Setting Rule and ensure network adequacy, which is federally required. This policy is required for all residential providers and facility-based providers listed below:

• Waiver Residential Providers
  • 1-2 bed adult family home (AFH)
  • 3-4 bed AFH
  • Community-based residential facility (CBRF)
  • Residential care apartment complex (RCAC)
• Waiver Aging and Disability Support Facility when any of the following services are provided:
  • Adult day care services
  • Day services — facility based
• Waiver Non-Residential Day and Vocational Facility when any of the following services are provided:
  • Adult day care services
  • Day services — facility based
  • Prevocational services — facility based

All other providers with multiple locations should call Provider Services to inquire whether they are required to complete multiple applications when applying for Medicaid enrollment.