STATE OF WISCONSIN
This memo provides counties with information on how to document and claim reimbursement for expenses incurred in administering the HealthCheck/Other Services initiative.
The HealthCheck/Other Services Initiative is being implemented to provide Medicaid coverage for certain treatment services provided in Residential Care Centers (RCCs) beginning in FY 05. RCCs are licensed child welfare agencies that provide residential and treatment services to children, youth, and young adults. Most children in RCCs are under the supervision of counties or (in Milwaukee County) the Bureau of Milwaukee Child Welfare.
Counties have several responsibilities under this initiative. Counties will sign a Certification of Public Expenditures (CPE) to verify Medicaid-reimbursable payments made to RCCs for services to their residents. Counties will pay an administrative fee to RCCs for their work under the initiative. Counties will process any required addendum language to their contracts with RCCs that allow and authorize payments being made. The following two CARS profiles have been created to reimburse counties for their administrative costs associated with implementing the HealthCheck/Other Services initiative and to reimburse counties for the administrative fee that is paid to the RCCs.
Counties shall report expenses incurred to administer the HealthCheck/Other Services initiative on CARS Profile #966. Administrative costs include expenses incurred in certifying RCC expenditures, processing the administrative fee payments to RCCs, and including addendum language in contracts with RCCs that participate in the initiative.
Counties shall report the administrative fees paid to RCCs on CARS Profile #967. The amount paid to RCCs is a percentage that is applied to the daily rate for only those kids that are prior authorized through Medical Assistance. The amount owed to each RCC is reflected on a financial report sent to counties.
Counties will report expenses on both profiles as costs are incurred. Reimbursement will be made to counties via the normal CARS reporting process.