BadgerCare Plus and Medicaid Updates

Welcome » April 25, 2024 3:32 PM

	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.

2015 ForwardHealth Updates

ForwardHealth Updates — 2015

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
2015-65	Overview and Clarification of Hearing Instrument Battery Policy, 12/28/15
2015-64	Changes to Reimbursement for Hospice Routine Care Services, 12/21/15
2015-63	SeniorCare Waiver Extended to December 31, 2018, 12/21/15
2015-62	New ForwardHealth Behavioral Treatment Benefit, 12/18/15 *December 28, 2015: This Update* had been revised since its original publication.** ForwardHealth has made minor revisions to pages 19 and 62. The changes are indicated in red text.
2015-61	January 2016 Preferred Drug List Review and Other Pharmacy Policy Changes, 12/18/15
2015-60	Reminder of ForwardHealth's Claim Submission Requirements and Reimbursement Policy for Outpatient Hospital Services, 12/2/15
2015-59	Prior Authorization Requirements and Coverage Policy for Restorative Plastic Surgeries and Procedures, 11/25/15
2015-58	ForwardHealth Holiday Schedule, 11/23/15
2015-57	Prior Authorization Required for Paliperidone Tablets, 11/02/15
2015-56	Ambulatory Surgical Center Access Payments Discontinued for Fiscal Year 2015, 10/27/15
2015-55	Provider Enrollment for the New Behavioral Treatment Benefit, 10/27/15
2015-54	Changes to Process for Submitting Birth to 3 Program Claims, 10/22/15
2015-53	Revised Hearing Aid Contract Models and Pricing Effective September 2015, 10/26/15
2015-52	Hospice Reimbursement Rate Changes, 10/20/15
2015-51	Clarification of the Completion Instructions for the Consent for Sterilization Form, 10/13/15
2015-50	Pharmacy Policy Changes Effective October 15, 2015, 10/5/15
2015-49	New Coverage and Prior Authorization Policy for Wearable Cardioverter Defibrillators, 10/2/15
2015-48	ForwardHealth Introduces Real-Time Eligibility Determinations for Qualified Applicants, 9/29/15
2015-47	ForwardHealth Will Not Issue Interim Payments for Claims Delayed Due to Lack of ICD-10 Readiness, 9/29/15
2015-46	Changes to Therapies Spell of Illness Prior Authorization Policy and Form, 9/23/15
2015-45	New Coverage and Prior Authorization Policy for Cranial Remolding Orthosis, 9/14/15
2015-44	Hospital Access Payments Discontinued for Fiscal Year 2015, 9/8/15
2015-43	New Prior Authorization Guidelines for Pectus Carinatum Surgery, 9/9/15
2015-42	Revised Prior Authorization Criteria and Documentation Requirements for Periodontal Scaling and Root Planing, 9/16/15
2015-41	New Policy Regarding Coverage and Prior Authorization Criteria for Hyperbaric Oxygen Therapy, 9/1/15
2015-40	New Requirements and Clarified Policy for Chiropractic Services, 8/26/15
2015-39	Effective Dates and Transition Information for ForwardHealth's Implementation of ICD-10 Code Sets, 8/21/15
2015-38	New Policy Regarding Diabetic Shoes and Inserts, 8/25/15
2015-37	New Coverage and Prior Authorization Policy for Orthopedic or Corrective Shoes and Foot Orthotics, 8/26/15
2015-36	Change to Prospective Drug Utilization Review Alerts, 8/10/15
2015-35	ICD-10 Diagnosis Codes for Targeted Case Management Services, 8/12/15
2015-34	Revised Prior Authorization Drug Attachment for Hepatitis C Agents Effective August 1, 2015, 7/22/15
2015-33	International Classification of Diseases, 10^th Revision, Testing for HMOs, 7/22/15
2015-32	Hearing Device Dispensing Fee Policy, 7/20/15
2015-31	School-Based Services Providers Will Be Required to Use ICD-10-CM Diagnosis Codes on Claims with Dates of Service on and After October 1, 2015, 7/7/15
2015-30	New Prior Authorization Approval Criteria for Reduction Mammoplasty, 7/2/15
2015-29	Drug-Related Supplies Reimbursed Fee-for-Service for Outpatient Pharmacies, 6/29/15
2015-28	ForwardHealth Is Reinstating the Explanation of Medical Benefits Form Requirements for Paper Claims and Paper Claim Adjustments with Other Health Insurance Indicated, 7/1/15
2015-27	July 2015 Preferred Drug List Review and Other Pharmacy Policy Changes, 6/17/15 *February 23, 2016: This Update* has been revised since its original publication.** Information under the Clinical Criteria for Pediatric-Covered Indications for Growth Hormone Drugs section has been added in red text on page 10 of the Update.
2015-26	ForwardHealth International Classification of Diseases, 10^th Revision, Open Testing Information, 6/8/15
2015-25	Information for Eligible Hospitals Regarding Program Year 2015 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/8/15 January 27, 2016: The deadline for all Eligible Hospitals to apply for Program Year 2015 Electronic Health Record incentive payments has been extended from January 31, 2016, to March 31, 2016.
2015-24	Information for Eligible Professionals Regarding Program Year 2015 of the Wisconsin Medicaid Electronic Health Record Incentive Program, 6/8/15 January 27, 2016: The deadline for all Eligible Professionals to apply for Program Year 2015 Electronic Health Record incentive payments has been extended from March 31, 2016, to July 31, 2016.
2015-23	Coverage Policy for Sleep Medicine Testing, 6/4/15
2015-22	Family Care and IRIS Coming to Northeast Wisconsin, 5/29/15
2015-21	Additional Cellular/Tissue-Based Product Covered by ForwardHealth, 5/27/15
2015-20	New Prior Authorization Criteria for Bone Growth Stimulators, 5/22/15
2015-19	Prior Authorization Changes for a Bone-Anchored Hearing Device Implant Surgery and Non-implant Bone-Anchored Hearing Device, 5/14/15
2015-18	Institutionalized Childless Adults Eligible for Long Term Nursing Home Care, 5/11/15
2015-17	Important Information and Reminders Related to ForwardHealth's Transition to International Classification of Diseases, 10^th Revision, Code Sets, 5/11/15
2015-16	Clarification of Copayment Exemptions for BadgerCare Plus and Medicaid Members, 4/22/15
2015-15	Upcoming Training Sessions Available for Providers Regarding International Classification of Diseases, 10th Revision Readiness, 3/26/15
2015-14	Outpatient and Inpatient Hospital Observation Policy, 3/26/15
2015-13	Changes to Pharmacy Policies for Hepatitis C Agents Effective April 1, 2015, 3/18/15
2015-12	Changes to Coverage Policies for Permanent Implantation of Intrathecal Infusion Pumps for Treatment of Spasticity, 3/18/15
2015-11	Revised Prior Authorization Requirements for Periodontal Scaling and Root Planing, 3/13/15
2015-10	New Coverage Policy for Testing for Drugs of Abuse, 3/12/15
2015-09	Clarification Regarding Comprehensive Medication Review and Assessment Services for Members Recently Discharged from a Hospital or Long Term Care Setting, 3/6/15
2015-08	2015 CPT and HCPCS Procedure Code Changes, 2/17/15
2015-07	Claims Submitted by End-Stage Renal Disease Service Providers Do Not Require Referring Provider Information, 2/17/15
2015-06	Coverage Policy for Low-Dose Computed Tomography Scans, 1/20/15
2015-05	STAT-PA Discontinued and Policy Changes for Foot Orthotics and Orthopedic or Corrective Shoes, 1/16/15
2015-04	Coverage Policy for Continuous Glucose Monitoring, 1/12/15
2015-03	Reminder Regarding Reimbursement Under the Enhanced Ambulatory Patient Groups System, 1/12/15
2015-02	Claims for Lead Testing Submitted by Special Supplemental Nutrition Program for Women, Infants, and Children Agencies Do Not Require Referring Provider Information, 1/12/15
2015-01	Affordable Care Act Primary Care Rate Increase Ended December 31, 2014, 1/5/15

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