In July 2014, the federal Centers for Medicare and Medicaid Services (CMS) directed states to cover autism treatment services under the Medicaid State Plan.
In response, the Department of Health Services (DHS) is transitioning coverage of autism treatment services from the Children's Long-Term Support (CLTS) Waiver Program to a new behavioral treatment benefit under ForwardHealth.
ForwardHealth began coverage of the new behavioral treatment benefit on January 1, 2016.
In order for a member to be eligible for the new behavioral treatment benefit:
Providers are required to be Medicaid-enrolled as a behavioral treatment provider in order to render behavioral treatment services under the new benefit. Providers may enroll as a behavioral treatment provider from the Provider Enrollment Information page on the ForwardHealth Portal. The October 2015 ForwardHealth Update (2015-55), "Provider Enrollment for the New Behavioral Treatment Benefit," contains detailed information on how to enroll in Wisconsin Medicaid.
The Behavioral Treatment Benefit service area of the Online Handbook is now available. The Online Handbook allows providers access to policy and billing information in one centralized place.
To begin using the Behavioral Treatment Benefit service area of the Online Handbook:
Once a topic is clicked, information will be displayed. Each topic is assigned a topic number, displayed above the topic title, for reference. A topic number may be entered into the Search and the Advanced Search tools to locate the corresponding topic. Topic numbers are for reference only and are not pertinent to the information contained within the topic or to the information in other topics with topic numbers assigned in close sequence.
This updated document contains links to numerous ForwardHealth resources applicable to the behavioral treatment benefit, including links to the Online Handbook, information about how to establish a secure Provider account on the Portal, and provider enrollment.
ForwardHealth has established an email box for behavioral treatment providers to submit questions related to coordinating the ForwardHealth benefit with the member's commercial insurance. Providers can submit questions to ForwardHealth at DHSBTCOB@wi.gov. Some inquiries may require research; therefore, additional time for responses may be required.
Providers should call Provider Services at 800-947-9627 or contact a Provider Relations representative for any other behavioral treatment-related questions.
ForwardHealth held in-person behavioral treatment provider training sessions throughout the state in February 2016. Handouts from the training are available below.
The Department of Health Services conducted provider training on the new behavioral treatment benefit on November 4, 2015, at the Mendota Mental Health Institute in Madison. A webcast of the training and additional handouts from the training are available below. Note: Information in these materials is current as of November 4, 2015, and is subject to change pending negotiations with CMS.
The Department of Health Services submitted the state plan amendment (SPA) to CMS in September 2015. Until the SPA is approved, dates may be subject to change. Refer to the public notice for more information about the SPA.
Because you have not recently performed an action that loads or reloads a page, your session will expire in Upon expiration your unsaved data will be lost and you will be required to login again to begin a new session. To avoid a session expiration, click this button to extend your session.
Extend