BadgerCare Plus and Medicaid Updates

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	Alerts
	Children’s Long-Term Support (CLTS) Program Providers and County Waiver Agencies: The CLTS Operations Team is available for your questions about submitting prior authorizations (PAs) or claims for CLTS services. Reach the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com. Attention CLTS Providers: The CLTS Prior Authorization Conversion is still processing. If you have any difficulties submitting claims, please contact the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com.

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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