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Family Care, Family Care Partnership, and PACE
Welcome  » April 25, 2024 10:05 AM
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Alerts
  • Change Healthcare (CHC) has begun submitting some batch X12 electronic transactions to ForwardHealth. The volume of backlogged claims held by CHC and the amount of time it will take CHC to send them is unknown. Once claims are acquired from CHC, ForwardHealth will process them in the order received.

    Visit the Change Healthcare Service Interruption: Resources page for more information on the security incident and for ForwardHealth resources.

  • Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences.
    Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.

Family Care, Family Care Partnership, PACE Providers


This information is for health care providers and service providers who contract with a managed care organization (MCO) to provide care or services to members.

For information specific to members, visit the Wisconsin Department of Health Services (DHS) site.

Eligibility and enrollment are managed by aging and disability resource centers (ADRCs) and local income maintenance agencies.
Information About Family Care Eligibility Policy
This page provides general information regarding eligibility or enrollment for Family Care.
MCO Contact Information
This is key contact information for each Family Care MCO.
 

Family Care, Family Care Partnership, and PACE Contracts
The contracts describe the mutual obligations of DHS and MCOs for the Family Care, Family Care Partnership, and PACE programs.
Technical Assistance and Memos
This page houses memos and technical assistance documents pertain to Family Care and Family Care Partnership.
Wisconsin Statutes for Family Care
These are the Wisconsin state laws that govern Family Care, specifically Wisconsin Statutes Chapter 46.
Wis. Admin. Code ch. DHS 10
This document describes the administrative rules that apply to Family Care.
Tribal Three-Party Agreement
This document describes a mutual agreement between DHS, a tribal nation, and an MCO.
Home and Community-Based Services (HCBS) Waivers
1915(b) HCBS Waiver — The federal Medicaid waiver permits the use of Medicaid funds for Family Care.
1915(c) HCBS Waiver — The HCBS waiver program is authorized in Social Security Act § 1915(c).
 

Electronic Visit Verification (EVV)
This page provides an overview of EVV and resources related to the required verification of personal care and supportive home care services.
Restrictive Measures Guidelines and Standards
This document provides the process and procedures for approval of use of restrictive measures.
 

MCO Scorecards
These annual scores are given to MCOs as a result of external quality review activities.
Geographic Service Region Maps
Regions of the state in which MCOs are contracted to provide Family Care, Family Care Partnership and
Program of All-Inclusive Care for the Elderly (PACE) services:
Family Care Geographic Service Regions
Partnership and PACE Geographic Service Regions
Family Care and IRIS Geographic Service Region Reconfiguration Timeline
Family Care, Family Care Partnership, and PACE Enrollment Data
These are monthly snapshots of Family Care, Family Care Partnership, and PACE enrollment data, which include data by MCO, county, and target populations.
COVID-19 Resources for Family Care, Family Care Partnership, and PACE MCOs
This page provides resources for MCOs specific to Family Care, Family Care Partnership, and PACE so they can better care for members. 
 

Payment Appeal Information for Providers
Provider appeal information can be found in Article VIII of the DHS-MCO state contract.
Restrictive Measures Guidelines and Standards
These are requirements for the use of restrictive measures for individuals who live in community settings in all Medicaid-funded adult long-term care programs.
Report Matrix
This page lists reports sent by DHS to MCOs and HMOs, including the frequency by which each report is sent.
Family Care Partnership Program Drug Carve Out Resources
DHS carved out coverage of most prescription outpatient drugs from the Family Care Partnership benefit package. This page provides resources that will help providers and administrators with the drug carve out transition.
 

Questions About Family Care?
Email Family Care
Call the Provider Services Call Center at 800-947-9627.
If you know a member with questions, direct them to call the Member Services Call Center at 800-362-3002.
Family Care and IRIS (Include, Respect, I Self-Direct) Ombudsman Program
This is information regarding the independent ombudsman program for people up to age 59 who are enrolled or in the process of enrolling in a long-term care program.
Wisconsin Board on Aging and Long-Term Care
This organization advocates for the state's long-term consumers ages 60 and older, informs those consumers of their rights, and educates the public about health care systems and long-term care.
MCO Contact Information
This is key contact information for each Family Care, Family Care Partnership, and PACE MCO.
 

What's New?
A summary of what is new for adult long-term care organizations:
 
 
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