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DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850

June 07, 2022

Lisa Olson Medicaid Director State of Wisconsin, Department of Health Services 1 West Wilson Street Room 350; P.O. Box 309 Madison, WI 53701‐0309

Dear Ms. Olson: On March 13, 2020, the President of the United States issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency by the authorities vested in him by the Constitution and the laws of the United States, including sections 201 and 301 of the National Emergencies Act (50 U.S.C. 1601 et seq.), and consistent with section 1135 of the Social Security Act (Act) as amended (42 U.S.C. 1320b-5). On March 13, 2020, pursuant to section 1135(b) of the Act, the Secretary of Health and Human Services invoked his authority to waive or modify certain requirements of titles XVIII, XIX, and XXI of the Act as a result of the consequences of the COVID-19 pandemic, to the extent necessary, as determined by the Centers for Medicare & Medicaid Services (CMS), to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the respective programs and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of such requirements as a result of the COVID-19 pandemic, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse. This authority took effect as of 6:00 PM Eastern Standard Time on March 15, 2020, with a retroactive effective date of March 1, 2020. We note that the emergency period will terminate, upon termination of the public health emergency (PHE), including any extensions.

For the reasons discussed below, CMS is approving an amendment to the Special Terms and Conditions (STCs) for Wisconsin’s section 1115(a) demonstration entitled, “Wisconsin SeniorCare” (Project Number 11-W-00149/5). The amendment provides expenditure authority, to the extent necessary, for state payments to providers for the administration of a COVID-19 vaccine for the limited-benefit population enrolled in the Wisconsin SeniorCare section 1115 demonstration. To the extent necessary, this expenditure authority also applies, notwithstanding section 1903(b)(1) of the Act and implementing regulations at 42 CFR 431.625(d)(3), to state payments to providers for COVID-19 vaccinations that could have been paid for under Medicare Part B, but were not, because the beneficiary was eligible for enrollment in Medicare Part B but was not enrolled in Medicare Part B. The expenditure authority will be in effect from December 14, 2020 through and including June 5, 2022. Beginning June 6, 2022, through a separate CMS