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Wisconsin Chronic Disease Program

Wisconsin Chronic Disease Program

The Wisconsin Chronic Disease Program (WCDP) offers assistance to Wisconsin residents with chronic renal disease, hemophilia, and adult cystic fibrosis. The WCDP is funded entirely by state dollars. The program pays health care providers for disease-related services and supplies provided to certified WCDP participants after all other sources of payment have been exhausted.

Members

Wisconsin Chronic Disease Program members are responsible for certain copayments and annual deductibles determined by the program. Participants whose annual income exceeds 300 percent of the Federal Poverty Level must pay a certain percent of out-of-pocket expense before becoming eligible to receive WCDP benefits. The state seeks repayment of WDDP benefits provided to members under the Estate Recovery Program.
  • HIPAA Privacy Forms
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Authorization for Use or Disclosure — F-13153
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Access Request — F-13154
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Accounting Request — F-13155
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Alternate Communication Request — F-13156
    • Wisconsin Chronic Disease Program (WCDP) HlPAA Privacy Amendment Request — F-13157
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Complaint — F-13158
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Restriction Request — F-13159
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Revocation of Authorization — F-13160
  • HIPAA Privacy Publications
    • Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Notice — P-13091.

Chronic Renal Disease Program

To be eligible for the state funded Chronic Renal Disease Program (CRD), participants must be Wisconsin residents diagnosed as having end-stage renal disease. In addition, participants that are eligible for Medicare must pay Medicare Part B premiums in order to receive Wisconsin Chronic Disease Program (WCDP) renal disease benefits. If the participant is eligible for Medicare but chose to delay Medicare participation, the participant is not eligible to receive WCDP renal disease benefits until the participant begins paying Medicare Part B premiums.
If a CRD participant is a Medicare participant at the time of application, the eligibility date is determined by the date of the initial treatment. However, if the participant is Medicare-eligible but has chosen not to pay for premiums, the WCDP eligibility date is designated as the date that Medicare benefits are initiated.

Chronic Renal Disease participants are eligible to receive the following WCDP covered services:
  • Inpatient and outpatient dialysis and transplant treatments.
  • One pre-transplant dental examination, and X-rays.
  • Kidney donor transplant-related medical services.
  • Certain prescription medications.
  • Certain home supplies.
  • Certain laboratory and X-ray services.
The WCDP text formularies are no longer available. Please use the Drug Search Tool to locate and verify current available WCDP NDCs
  • Financial Need Cover Memo — F-1194, Statement — F-1189, and Instructions —F-1189A.
  • Application — F-1186, and Instructions — F-1186A.
  • Residency and Health Care Benefits Verification — F-1143.
  • Income Deductible for the Wisconsin Chronic Disease Program — P-1190.
  • Important Notice about the Wisconsin Chronic Renal Disease Program Drug Benefit — F-1058.
  • Liability Chart — P-1193
  • Wisconsin Chronic Renal Disease Program Brochure — P-1147A.

Hemophilia Home Care Program

To be eligible for the state funded Hemophilia Home Care (HHC) program, and the participants must be a Wisconsin resident diagnosed by a comprehensive hemophilia treatment center as having hemophilia. The participant must also enter into a written agreement with a comprehensive hemophilia treatment center for compliance with a maintenance program. Hemophilia Home Care participants become eligible for Wisconsin Chronic Disease Program (WCDP) benefits on the date the application is received by the WCDP.

Hemophilia Home Care participants are only eligible to receive services for blood derivatives and supplies necessary for home infusion. A $10 participant copay will be applied to each prescription and blood product covered by the program.

The WCDP text formularies are no longer available. Please use the Drug Search Tool to locate and verify current available WCDP NDCs.
  • Financial Need Cover Memo — F-1195, Statement — F-1187, and Instructions — F-1187A.
  • Application — F-1184, and Instructions — F-1184A.
  • Residency and Health Care Benefits Verification — F-1145.
  • Income Deductible for the Wisconsin Chronic Disease Program — P-1190.
  • Liability Chart — P-1191.

Adult Cystic Fibrosis Program

To be eligible for the state funded Adult Cystic Fibrosis Program (ACF), a participant must be a Wisconsin resident diagnosed by the medical director of a cystic fibrosis treatment center as having cystic fibrosis and be 18 years of age or older. Adult cystic fibrosis participants are not eligible for retroactive eligibility; therefore, they become eligible for Wisconsin Chronic Disease Program (WCDP) benefits on the date the application was received by the WCDP.

Adult Cystic Fibrosis participants are eligible to receive the following WCDP covered services:
  • Inpatient and outpatient services directly related to the disease.
  • Certain physician services.
  • Certain laboratory and X-ray services.
  • Certain prescription medications.
  • Certain home supplies.

The WCDP text formularies are no longer available. Please use the Drug Search Tool to locate and verify current available WCDP NDCs.
  • Financial Need Cover Memo — F-1196, Statement — F-1188, and Instructions — F-1188A.
  • Application — F-1185, and Instructions — F-1185A.
  • Residency and Health Care Benefits Verification — F-1144
  • Income Deductible for the Wisconsin Chronic Disease Program — P-1190.
  • Liability Chart — P-1192.

Related Links

  • Wisconsin Chronic Disease Program Member Handbook — P-1147.
  • Wisconsin Chronic Disease Program Policies Coverage of Enteral Nutrition Products — P-1147B.
  • Estate Recovery Fact Sheet for WCDP participants.

Providers

Providers should reference the Drug Search Tool for each program regularly to determine drug coverage and appropriate copayment amounts.
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