Under the leadership of Governor Walker, the Department of Health Services (DHS) Division of Medicaid Services (DMS) is pleased to announce that effective January 1, 2018, we will increase reimbursement for outpatient mental health (MH) and substance use disorder (SUD) treatment.

We have heard the feedback from our partners in the MH and SUD provider community regarding the barriers they face in meeting the demand for these important services. Generally, financial mechanisms alone will not resolve many of the health care challenges of our state.  However, by increasing Medicaid rates and removing the administrative burden of prior authorization for outpatient mental health providers, we expect that our members will have improved access to treatment services by encouraging licensed providers to enroll with Wisconsin Medicaid. To enroll in the Medicaid program, go to the ForwardHealth Portal.

DMS will invest $7 million GPR annually to increase rates for MH and SUD. This substantial investment will make Wisconsin Medicaid a rate leader in the Great Lakes region in terms of provider reimbursement for MH and SUD treatment.

This announcement will be followed soon by a ForwardHealth Update with additional details of the rate increase and billing guidance for fee-for-service providers. DMS will provide guidance to HMOs on the rate/billing guidance changes and will adjust our HMO capitation rates (and encounter data submission process) effective January 1, 2018, to assure alignment.

I hope this investment by Governor Walker will spur you to enhance and expand mental health and substance abuse services to our residents in need.  We look forward to our continued partnership and collaboration on behalf of our members.

Michael Heifetz

Medicaid Director