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Wisconsin BadgerCare Reform Approval Period: October 29, 2024 through December 31, 2029 Page 3 CENTERS FOR MEDICARE AND MEDICAID SERVICES SPECIAL TERMS AND CONDITIONS
NUMBER: 11-W-00293/5
TITLE: Wisconsin BadgerCare Reform
AWARDEE: Wisconsin Department of Health Services
1. PREFACE
The following are the Special Terms and Conditions (STCs) for the “Wisconsin BadgerCare Reform” section 1115(a) Medicaid demonstration (hereinafter “demonstration”), to enable the Wisconsin Department of Health Services (hereinafter “state”) to operate this demonstration. The Centers for Medicare & Medicaid Services (CMS) has granted expenditure authorities authorizing federal matching of demonstration costs not otherwise matchable, which are separately enumerated. These STCs set forth conditions and limitations on those expenditure authorities, and describe in detail the nature, character, and extent of federal involvement in the demonstration and the state’s obligations to CMS related to the demonstration. These STCs neither grant additional waivers or expenditure authorities, nor expand upon those separately granted.
The STCs related to the programs for those populations affected by the demonstration are effective from October 29, 2024 through December 31, 2029, unless otherwise specified. The STCs have been arranged into the following subject areas:
1. Preface 2. Program Description and Objectives 3. General Program Requirements 4. Eligibility and Enrollment 5. Benefits 6. Cost Sharing 7. Delivery System 8. Monitoring and Reporting Requirements 9. Evaluation of the Demonstration 10. General Financial Requirements 11. Monitoring Budget Neutrality for the Demonstration 12. Schedule of Deliverables for the Demonstration Period
Additional attachments have been included to provide supplementary information and guidance for specific STCs.
Attachment A. Substance Use Disorder Implementation Plan Protocol (Approved) Attachment B. Substance Use Disorder Monitoring Protocol (Reserved) Attachment C. Developing the Evaluation Design Attachment D Preparing the Interim and Summative Evaluation Reports