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Updates for local agencies, community-based organizations, and providers who provide assistance to members of Wisconsin's health and nutrition public assistance programs.
DHS Seeking Five-Year Extension to BadgerCare 1115 Waiver
The Department of Health Services (DHS) will submit an application to the Centers for Medicare and Medicaid Services (CMS) on or around November 15, 2022. It will request a five-year extension of the current Medicaid 1115 Research and Demonstration Waiver. DHS is not seeking changes. The next demonstration period runs from January 1, 2024, to December 31, 2028. Learn more about the proposed waiver extension.
The current waiver provides coverage to the childless adult and transitional medical assistance populations. It also gives Wisconsin authority to implement additional eligibility and cost-sharing components for childless adults, including premiums, copayments for non-emergency use of the emergency department, and a health risk assessment as a condition of eligibility. The waiver also provides coverage of short-term residential services in facilities that qualify as institutions for mental diseases for all Medicaid enrollees.
As of July 1, 2022, more than 277,000 individuals receive coverage under this demonstration authority.
Public Hearings
The public comment period for the waiver extension is September 12 – October 14, 2022. DHS will hold two virtual public hearings to gather input, on September 21 and September 28, 2022. For details about the hearings and instructions to join via Zoom, please refer to the abbreviated public notice.
About the Waiver
The BadgerCare waiver provides robust state plan benefits to childless adults who are not pregnant, disabled, or elderly with incomes of up to and including 100% of the federal poverty level and to transitional medical assistance individuals, also known as members on extension, with incomes over 100% of the federal poverty level.
The waiver includes a substance use disorder program that expands the substance use disorder benefits package to cover short-term residential services in facilities that qualify as institutions for mental diseases for all Medicaid enrollees.
The waiver also allows Wisconsin to implement additional eligibility and cost-sharing components that apply only to the nonmandatory childless adult population.
DHS must get approval from CMS to extend the BadgerCare waiver beyond December 31, 2023.
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