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Wisconsin BadgerCare Reform Demonstration Approval Period: October 29, 2024 through December 31, 2029

Inpatient Services This is an existing service under the State Plan. Coverage for inpatient services will expand to include any previously excluded IMD providers. Wisconsin Medicaid will provide coverage and reimbursement policy guidance to any facilities previously excluded from providing treatment due to categorization as an IMD. Policy guidance will be distributed to providers by November 2020. Medically Supervised Withdrawal Management This is an existing service under the State Plan. Coverage for medically supervised withdrawal management will expand to include any previously excluded IMD providers. Wisconsin Medicaid will provide coverage and reimbursement policy guidance to any facilities previously excluded from providing treatment due to categorization as an IMD. Policy guidance will be distributed to providers by November 2020.

2.2 Use of Evidence-based, SUD-specific Patient Placement Criteria

Wisconsin Medicaid establishes standards for the use of patient placement criteria in Administrative Code Chapter DHS 75, “Community Substance Abuse Service Standards.” These standards already establish requirements for certified SUD treatment programs to use approved patient placement criteria. Further, the Wisconsin Department of Health Services (DHS) is currently drafting language to revise ch., DHS 75, including updated references to ASAM guidelines.