Major changes could soon be in store for Wisconsin’s medical assistance programs. The state Department of Health Services offered a long list of proposals Friday aimed at finding over $544 million in costs savings, many of which would alter the way programs such as BadgerCare operate.
Those changes could include more controls on reimbursement rates to providers, hiring auditors to monitor payments, and a medical home initiative that will help to better track the costs of coverage for certain at-risk groups. The proposal also includes a request for a federal waiver, which would allow the state to make major changes to eligibility requirements for BadgerCare programs.
Department Secretary Dennis Smith says the waiver is needed because the federal health care law passed under President Obama locked states in to their current requirements, making it impossible for the state to make the changes needed to areas such as premium rates, residency requirements, and income determinations. Without one, Smith says the state’s only option may be to drop over 53,000 people from BadgerCare programs to help achieve the cost savings the state needs.
State health officials could not say how many people could see their coverage dropped or rates increased if the waiver is approved, although they say individuals and families living below the federal poverty line or who are disabled would see no changes in benefits.
Many of the proposals will need approval from the Legislature or the federal government before they could be implemented.