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(a) When services are reimbursable.
Services under s. 49.46 (2) (b) 6. Lm. provided to an individual are reimbursable under the medical assistance program only if all of the following conditions are met: 1. Reimbursement for the services under s. 49.46 (2) (b) 6. Lm. in the manner provided under this subsection is permitted pursuant to federal law or pursuant to a waiver from the secretary of the federal department of health and human services. 2. The county in which the individual resides elects to make the services under s. 49.46 (2) (b) 6. Lm. available in the county through the medical assistance program. 3. The individual’s psychosocial health needs require more than outpatient counseling, but less than the services provided by a community support program under s. 51.421. 4. The psychosocial services are provided by a community-based psychosocial service program certified under rules promulgated by the department under par. (b) 3. 5. Any other condition required by rule under par. (b) 4. is satisfied.
Reimbursement for the services under s. 49.46 (2) (b) 6. Lm. in the manner provided under this subsection is permitted pursuant to federal law or pursuant to a waiver from the secretary of the federal department of health and human services.
The county in which the individual resides elects to make the services under s. 49.46 (2) (b) 6. Lm. available in the county through the medical assistance program.
The individual’s psychosocial health needs require more than outpatient counseling, but less than the services provided by a community support program under s. 51.421.
The psychosocial services are provided by a community-based psychosocial service program certified under rules promulgated by the department under par. (b) 3.
Any other condition required by rule under par. (b) 4. is satisfied.
The department shall promulgate rules regarding all of the following: 1. Standards for determining whether an individual is eligible under par. (a) 3. 2. The scope of psychosocial services that may be provided under s. 49.46 (2) (b) 6. Lm. 3. Requirements for certification of community-based psychosocial service programs. 4. Any other conditions for coverage of community-based psychosocial services under the Medical Assistance Program.
Standards for determining whether an individual is eligible under par. (a) 3.
The scope of psychosocial services that may be provided under s. 49.46 (2) (b) 6. Lm.
Requirements for certification of community-based psychosocial service programs.
Any other conditions for coverage of community-based psychosocial services under the Medical Assistance Program.
A county that elects to make the services under s. 49.46 (2) (b) 6. Lm. available shall reimburse a provider of the services for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government. The department shall reimburse the provider only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.
Notwithstanding par. (c) and subject to par. (e), in counties that elect to deliver the services under s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis according to criteria established by the department, the department shall reimburse a provider of the services for the amount of the allowable charges for those services under the Medical Assistance program that is provided by the federal government and for the amount of the allowable charges that is not provided by the federal government.
1. Prior to implementing, and receiving funding for implementing, the regional basis provision of services under par. (d), the department shall submit to the joint committee on finance, no later than March 1, 2014, a request for the release of funds and a report on its proposal for implementation that includes all of the following: a. A description of the criteria that the department will apply in its regionalization model. b. A description of how the regions will be established and the degree of county participation in that process. c. An updated list of the counties that have indicated, by the date of the report, that they will offer the services under s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis according to the criteria established by the department. d. An evaluation of the estimated long-term costs of the proposed regional model. 2. If the cochairpersons of the committee do not notify the department within 14 working days after the date that the department submits the report and the funding request that the committee has scheduled a meeting for the purpose of reviewing the proposal for implementation and the funding request, the funding shall be released and the department may implement its proposal for the regional basis provision of services on July 1, 2014. If, within 14 working days after the date that the department submits the report and the funding request, the cochairpersons notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposal for implementation and the funding request, the funding shall be released, and the department may implement its proposal for the regional basis provision of services, only upon approval of the committee.
Prior to implementing, and receiving funding for implementing, the regional basis provision of services under par. (d), the department shall submit to the joint committee on finance, no later than March 1, 2014, a request for the release of funds and a report on its proposal for implementation that includes all of the following: a. A description of the criteria that the department will apply in its regionalization model. b. A description of how the regions will be established and the degree of county participation in that process. c. An updated list of the counties that have indicated, by the date of the report, that they will offer the services under s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis according to the criteria established by the department. d. An evaluation of the estimated long-term costs of the proposed regional model.
A description of the criteria that the department will apply in its regionalization model.
A description of how the regions will be established and the degree of county participation in that process.
An updated list of the counties that have indicated, by the date of the report, that they will offer the services under s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis according to the criteria established by the department.
An evaluation of the estimated long-term costs of the proposed regional model.
If the cochairpersons of the committee do not notify the department within 14 working days after the date that the department submits the report and the funding request that the committee has scheduled a meeting for the purpose of reviewing the proposal for implementation and the funding request, the funding shall be released and the department may implement its proposal for the regional basis provision of services on July 1, 2014. If, within 14 working days after the date that the department submits the report and the funding request, the cochairpersons notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposal for implementation and the funding request, the funding shall be released, and the department may implement its proposal for the regional basis provision of services, only upon approval of the committee.