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  • 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.
Professional Dispensing Fee Survey

Professional Dispensing Fee Survey

Because the Covered Outpatient Drugs Final Rule impacted current covered outpatient drug reimbursement policy, including dispensing fee reimbursement, ForwardHealth contracted with a health care consulting firm, Mercer, to conduct the Professional Dispensing Fee survey in June 2016. The survey was used to obtain necessary information on the costs associated with dispensing covered outpatient drugs to ForwardHealth members. ForwardHealth used the data collected from the Professional Dispensing Fee survey to determine its proposed professional dispensing fees.

Based on the data collected from the Professional Dispensing Fee survey, ForwardHealth initially proposed changes to its outpatient drug reimbursement policies: Refer to the March 2017 ForwardHealth Update (2017-07), titled "Changes to Billing and Reimbursement Policy for Covered Outpatient Drugs," with the billing and drug reimbursement policies effective April 1, 2017.
 
 
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Wisconsin Department of Health Services
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