BadgerCare Plus and Medicaid Updates

Welcome » May 19, 2024 6:40 AM

	Alerts
	Ascension Password Change: On May 8, 2024, a cyber security event disrupted clinical operations of the Ascension Healthcare Network. To ensure the security of protected health information on the ForwardHealth Portal, ForwardHealth will prompt all providers owned by Ascension to change their password. Providers not owned by Ascension will not be prompted to change their password. For instructions on changing your Portal password, refer to the ForwardHealth Provider Portal Account User Guide. 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.

2014 ForwardHealth Updates

ForwardHealth Updates — 2014

These publications are available only as PDFs. You will need Adobe Reader^® to view these files.

Update Number	ForwardHealth Update Topic(s) and release date
2014-79	Changes to Provider-Administered Drugs Carve-Out Policy, 12/16/14
2014-78	January 2015 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/18/14
2014-77	Change to Requirement Regarding Electronic Submission of Medication Therapy Management Documentation, 12/11/14
2014-76	ForwardHealth Is Postponing the Explanation of Medical Benefits Form Requirement for Paper Claims and Paper Claim Adjustments with Other Health Insurance Indicated, 12/10/14
2014-75	Procedure Code Changes for Influenza Vaccinations, 12/4/14
2014-74	Changes to Pharmacy Policies for Hepatitis C Agents Effective December 1, 2014, 11/19/14
2014-73	Reminder Regarding Use of Diagnosis Codes for School-Based Services, 11/5/14
2014-72	Clarification of Policy Regarding Inpatient and Outpatient Hospitals Submitting Claims for Certain Services on a Professional Claim, 11/6/14
2014-71	Changes for Program Year 2014 of the Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Professionals, 10/30/14
2014-70	Changes for Program Year 2014 of the Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Hospitals, 10/30/14
2014-69	Upcoming Training Sessions Available for Therapists Regarding ForwardHealth Portal Functionality, 10/24/14
2014-68	New Program Requirements for Dispensing Clotting Factor Concentrates, 10/27/14
2014-67	ForwardHealth Holiday Schedule, 10/22/14
2014-66	New Policy Regarding the Allowable Length of Observation Prior to Inpatient Hospital Admission, 10/20/14
2014-65	Reminder to Indicate Correct Dates on Inpatient Hospital Claims, 10/20/14
2014-64	Orthopedic or Corrective Shoes and Foot Orthotics Coverage and Prior Authorization Policy, 10/22/14
2014-63	Coverage Policy for Cellular/Tissue-Based Products, 10/10/14
2014-62	Changes to the 1500 Health Insurance Claim Form and Completion Instructions, 10/14/14
2014-61	New Requirements for Paper Claims and Paper Claim Adjustments with Other Health Insurance Indicated, 10/14/14
2014-60	2014 Rate Changes for Services Receiving Only Federal Funds, 10/1/14
2014-59	Coverage of Services Rendered in Walk-In Retail or Convenient Care Clinics, 10/1/14
2014-58	Submitting Claims for Physical Therapy, Occupational Therapy, and Speech and Language Pathology Evaluations and Re-evaluations Provided in Outpatient Hospital Specialty Clinics, 9/30/14
2014-57	Rate Changes for Case Management Services, 9/29/14
2014-56	Hospice Reimbursement Rate Changes, 9/30/14 July 1, 2015: This Update has been revised since its original publication. The reimbursement rates for revenue codes 0651, 0652, and 0655 have been revised. Revisions are on page 2 and are indicated in red.
2014-55	Changes to Pharmacy Policies Effective October 1, 2014, 9/17/14
2014-54	Revised Hearing Aid Contract Models and Pricing Effective September 2014, 9/16/14 October 29, 2014: This Update has been revised since its original publication. Pricing information for two Phonak Hearing Systems full shell hearing aid models (see page 9 of Attachment 2) has been revised. Revisions are indicated in red.
2014-53	Revised Prior Authorization Guidelines for Synagis^®, 9/15/14 *September 16, 2014: This Update* has been revised since its original publication.** Information under the Chronic Lung Disease of Prematurity section has been changed to clarify the gestational age at delivery is younger than 32 weeks. Revisions are indicated in red.
2014-52	Hospital Access Payments Discontinued for Fiscal Year 2014, 9/29/14
2014-51	ForwardHealth Updating the Web-Based Express Enrollment Application Tool to Include Express Enrollment for Family Planning Only Services, 9/10/14
2014-50	Updated Process for Qualified Hospitals to Make Presumptive Eligibility Determinations for Individuals, 9/9/14
2014-49	Clarifications Regarding Coding Requirements for Intrathecal Pump Prior Authorizations, 9/4/14
2014-48	Federal Fiscal Year 2015 Rate Changes for School-Based Services, 9/3/14
2014-47	Claim Submission Changes for Professional Services for the Outpatient Mental Health Benefit, 8/19/14
2014-46	Upcoming Training Sessions Available for Chiropractors Regarding ForwardHealth Portal Functionality, 8/11/14
2014-45	Medication Therapy Management New Electronic Submission of Documentation Requirement, 8/18/14
2014-44	New and Clarified Claim Submission Policy for Nurse Midwife Services, 7/22/14
2014-43	Functionality Added to the Demographic Maintenance Tool for Reporting Licensure Information, 7/16/14
2014-42	Changes to the Comprehensive Community Services Benefit as a Result of the Wisconsin 2013-15 Biennial Budget, 6/30/14
2014-41	Ambulatory Surgical Center Access Payments Discontinued for Fiscal Year 2014, 6/26/14
2014-40	Claim Submission Changes for Travel Time and Professional Services for the Outpatient Mental Health and Substance Abuse Services in the Home or Community for Adults Benefit, 6/24/14
2014-39	July 2014 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/20/14
2014-38	Ambulatory Surgery Center Access Payment Changes for State Fiscal Year 2015, 6/16/14
2014-37	Coverage Policy for Emerging Molecular Pathology and Diagnostic Genetic Testing, 6/13/14
2014-36	ForwardHealth Is Postponing Implementation of New Reimbursement Policy for Certain Claims and Claim Adjustments with Other Commercial Health Insurance Indicated, 6/9/14
2014-35	Scheduled Maintenance Will Result in Planned Downtime for ForwardHealth, 5/27/14
2014-34	New Requirements for Certain Claims and Claim Adjustments with Other Commercial Health Insurance Indicated, 5/14/14
2014-33	New Requirements for Information Sharing Between Prenatal Care Coordination Providers and State-Contracted HMOs, 5/9/14
2014-32	Reimbursement for Ambulance Emergency and Non-emergency Medical Transportation Ground Services, 4/25/14
2014-31	ForwardHealth International Classification of Diseases, 10th Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Procedure Coding System Implementation Is Postponed, 4/23/14
2014-30	2014 Procedure Code Changes for Durable Medical Equipment, 4/30/14
2014-29	Clarification of Specialized Medical Vehicle Driver Training Requirements for Cardiopulmonary Resuscitation, 4/16/14
2014-28	Demographic Maintenance Tool Enhancements, 4/16/14
2014-27	Revised Companion Guides for the 270/271 Health Care Eligibility and Benefit Inquiry and Response and 276/277 Health Care Claim Status Request and Response Transactions Available, 4/11/14
2014-26	New Prior Authorization Criteria for Intrathecal Infusion Pumps for Spasticity or Pain, 4/23/14
2014-25	Change to Type of Bill Code for Home Health Claims, 4/8/14
2014-24	2014 Procedure Code Changes for Disposable Medical Supplies, 3/31/14
2014-23	New Reimbursement Policy for Certain Claims and Claim Adjustments with Other Commercial Health Insurance Indicated, 3/31/14
2014-22	Revision to Durable Medical Equipment Coverage, Policies, and Limitations, 4/30/14
2014-21	Simplified Process for Requesting Prior Authorization for Speech and Language Pathology Services Directly Following the Purchase of a ForwardHealth-Prior Authorized Speech Generating Device, 4/1/14
2014-20	Policy Changes for Alpha Hydroxyprogesterone Caproate (17P) Compound Injections and Makena Injections, 3/31/14
2014-19	Ambulatory Surgical Center Access Payment Changes for the Remainder of State Fiscal Year 2014, 3/28/14
2014-18	Clarification of Policy Regarding Access Payments for Childless Adults Enrolled in the BadgerCare Plus Standard Plan, 3/28/14
2014-17	Wisconsin Medicaid Will Reimburse Hospitals for State Prison Inmate Inpatient Hospital Stays, 3/21/14
2014-16	Changes in How Nurse Practitioners and Nurses in Independent Practice Who Provide Respiratory Care Services Report Certain Training Information, 3/21/14
2014-15	Specialized Medical Vehicle Providers Will Be Required to Report Vehicle and Driver Information Through the ForwardHealth Portal, 3/6/14
2014-14	Personal Care Providers Can Now Upload Personal Care Screening Tool Reports Using the ForwardHealth Portal, 3/10/14
2014-13	Prior Authorization Required for Sovaldi^™, 3/3/14
2014-12	Changes to BadgerCare Plus Due to the Affordable Care Act and 2013-15 Wisconsin Act 20, 2/27/14
2014-11	ForwardHealth's Transition to International Classification of Diseases, 10th Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Procedure Coding System Code Sets, 2/26/14
2014-10	Effective April 1, 2014, Qualified Hospitals Allowed to Make Presumptive Eligibility Determinations, 2/17/14
2014-09	New Speech and Language Pathology Evaluation Procedure Codes for Therapy and Birth to 3 Providers, 2/17/14
2014-08	Changes to Pharmacy Policies Effective March 1, 2014, 2/17/14
2014-07	New Speech and Language Pathology Evaluation Procedure Codes for School-Based Services Providers, 2/12/14
2014-06	Changes to Express Enrollment Policy and Revisions to Express Enrollment Applications and Instructions, 2/14/14
2014-05	Revised Procedure Code List for the New State Purchase Eyeglass Contract, 2/3/14
2014-04	Reminder Regarding Home Health and Personal Care Agency Personnel Reporting Requirements and Revalidation Information, 2/3/14
2014-03	Providers Are Required to Report a Change in Ownership Within 35 Days, 1/17/14
2014-02	Health Care Providers and Partners Are Now Required to Apply on the ForwardHealth Portal to Become Express Enrollment Providers, 1/15/14
2014-01	New Prior Authorization Criteria for Panniculectomy and Lipectomy Surgeries, 1/10/14

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