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Wisconsin Department of Health Services

Medicaid Managed Care

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What's New

2007 HMO Report Card
2008 BadgerCare Plus HMO Service Area Map and Service Area Grid
BadgerCare Plus and Medicaid SSI Contract (PDF, 723 KB)
The Wisconsin BadgerCare Plus HMO Program Guide, PHC 12020 (02/08)
- Translations
  - Hmong
  - Russian
  - Spanish
Wisconsin BadgerCare Plus Choice Booklet, PHC 12020A (02/08)
- Translations
  - Hmong
  - Russian
  - Spanish
Wisconsin Medicaid SSI HMO Program Guide, PHC 12770 (02/08)
- Translations
  - Hmong
  - Russian
  - Spanish
Medicaid SSI HMO Choice Booklet, PHC 12770A (02/08)
- Translations
  - Hmong
  - Russian
  - Spanish
Medicaid SSI HMO Choice Booklet — Southwest Counties, PHC 12770B (02/08)
- Translations
  - Hmong
  - Russian
  - Spanish
Ombuds Brochure, PHC 12002 (02/08)
Updated SSI Expansion Map, 1/7/08 (PDF, 94 KB)
SSI Managed Care (PDF, 160 KB)
Children Come First (Dane County) Contract (PDF, 327 KB)
Wraparound Milwaukee (WM) Contract (PDF, 314 KB)
2007 External Quality Review Report (PDF, 293 KB)

Recipients

Publications
- The Wisconsin BadgerCare Plus HMO Program Guide, PHC 12020 (02/08)
  - Translations
    - Hmong
    - Russian
    - Spanish
- Wisconsin BadgerCare Plus Choice Booklet, PHC 12020A (02/08)
  - Translations
    - Hmong
    - Russian
    - Spanish
- Wisconsin Medicaid SSI HMO Program Guide, PHC 12770 (02/08)
  - Translations
    - Hmong
    - Russian
    - Spanish
- Medicaid SSI HMO Choice Booklet, PHC 12770A (02/08)
  - Translations
    - Hmong
    - Russian
    - Spanish
- Medicaid SSI HMO Choice Booklet — Southwest Counties, PHC 12770B (02/08)
  - Translations
    - Hmong
    - Russian
    - Spanish
- Ombuds Brochure, PHC 12002 (02/08)
- Mental Health in Managed Care — Wisconsin Medicaid and BadgerCare Fact Sheet
- Stay Safe and Healthy — Here are some ways you can help your doctor care for you and your family.
Quality Reports
SSI Medicaid Managed Care Expansion
- Updated SSI Expansion Map, 1/7/08 (PDF, 94 KB)

Providers

Certifications, Contracts, and MOUs
- Children Come First (Dane County) Contract (PDF, 327 KB)
- BadgerCare Plus and Medicaid SSI Contract (PDF, 1297 KB)
- Wraparound Milwaukee (WM) Contract (PDF, 314 KB)
Financial Information
- 2008 BadgerCare Plus and Medicaid SSI Rates — Exhibit Section (PDF, 574 KB)
- 2007 SSI HMO Rates
  - Milwaukee Region (PDF, 51 KB)
  - Southeast Region (PDF, 47 KB)
  - Southwest Region (PDF, 47 KB)
- Office of Commissioner of Insurance Financial Reports
Quality Reports
SSI Medicaid Managed Care Expansion
- Updated SSI Expansion Map, 1/7/08 (PDF, 94 KB)
Trading Partner Profile (TPP) Information for Managed Care
- 834 Schedule
- Managed Care TPP (fillable PDF, 80 KB)
- Managed Care TPP — Completion Instructions

Contacts

Provider Contacts
- Who to Call
- HMO Mental Health Contact Numbers
Recipient Contacts
- Recipient Services and County and Tribal Transportation telephone numbers
- Social Security Offices in Wisconsin
- Social Security Administration Web Site
- Wisconsin Medicaid Managed Care Programs, State-Contracted HMOs
- Wisconsin Medicaid Special Managed Care Programs
- Wisconsin Medicaid SSI Managed Care Organizations
- Division of Supportive Living, Bureau of Quality Assurance (BQA) — Regional Offices

Advisory Committees

HMO
- Meeting Notices
  - 8/18/04
- Meeting Minutes
  - 8/18/04
SSI Expansion
- Dane County (No longer enrolling SSI recipients as of 7/1/07)
  - Open Meeting Notices
    - 4/12/06
    - 9/30/05
    - 8/25/05
    - 6/18/05
    - 5/13/05
    - 4/1/05
    - 2/25/05
    - 1/28/05
    - 12/17/04
    - 11/15/04
    - 9/24/04
    - 7/30/04
    - 6/24/04
  - Meeting Minutes
    - 9/30/05
    - 8/25/05
    - 8/8/05
    - 7/8/05
    - 5/13/05
    - 4/1/05
    - 2/25/05
    - 1/28/05
    - 12/17/04
    - 11/15/04
    - 9/24/04
    - 7/30/04
    - 6/24/04
  - Workgroup
    - Town Hall
      - Meeting Minutes
        
        10/21/05
        
        9/20/05
        
        8/31/05
        
        7/25/05
        
        6/30/05
        
        5/31/05
        
        4/28/05
        
        4/20/05
    - Quality Assurance
      - Meeting Minutes
        
        10/11/05
        
        6/22/05
        
        5/11/05
        
        4/13/05
        
        2/16/05
        
        1/21/05
        
        12/13/04
        
        11/19/04
        
        10/27/04
        
        9/14/04
  - Supporting Documentation
    - Analysis on Participating Populations in the SSI Dane County Managed Care Program, 7/30/04
    - Dane County SSI Sub-Populations (SFY 2002, 18+ year olds, excluding managed care enrollees)
    - Enrollment Options for SSI-Medicaid Managed Care in Dane County — Draft (PDF, 105 KB)
    - MEDS Directive regarding Data for SFY 2001, 2002 and 2003 SSI FFS Population
    - Memo to the Honorable Kitty Rhoades, Wisconsin State Assembly from Mark Moody, DHCF Administrator, 6/24/04
    - SSI Dane County Rates for Community Support Program (CSP) or Targeted Case Management (TCM)
- Milwaukee County
  - Open Meeting Notices
    - 2/15/06
    - 12/07/05
    - 10/10/05
    - 9/21/05
    - 7/13/05
    - 5/4/05
    - 3/22/05 — Change of Meeting Site
    - 3/2/05
    - 2/17/05
    - 1/19/05
    - 12/8/04
    - 11/3/04
    - 10/6/04
    - 9/8/04
    - 8/4/04
    - 7/7/04
  - Meeting Minutes
    - 5/4/05
    - 12/8/04
    - 10/6/04
    - 9/8/04
    - 8/4/04
    - 7/7/04
  - Supporting Documentation
    - Request for Proposal SSI Medicaid Managed Care Milwaukee County External Advocate (PDF, 323 KB)
    - Timeline for SSI Managed Care Implementation (PDF, 7 KB)
    - Subcommittees and Responsibilities, 7/29/04
    - Highlights of Federal Requirements for State Managed Care Programs, 8/4/04 (PDF, 537 KB) or PowerPoint presentation (PPT, 57 KB)
  - Workgroup
    - Consumer Rights and Enrollments
      - Open Meeting Notices
        
        9/20/04
        
        9/8/04
      - Meeting Minutes
        
        9/8/04
    - Quality Assurance
      - Open Meeting Notices
        
        2/15/06
        
        5/23/05
        
        4/11/05
        
        3/16/05
        
        2/24/05
        
        1/24/05
        
        9/8/04
      - Meeting Minutes
        
        5/23/05
        
        4/11/05
        
        3/16/05
        
        2/24/05
        
        1/24/05
        
        9/8/04
    - Rate Setting
      - Open Meeting Notices
        
        12/15/04
        
        10/13/04
    - Scope of Services and Network Adequacy
      - Open Meeting Notices
        
        9/20/04
        
        9/8/04
      - Meeting Minutes
        
        9/20/04
        
        9/8/04
- Southeastern (Kenosha, Racine, and Waukesha) Counties
  - Open Meeting Notices
    - 5/24/06
    - 4/3/06 (PDF, 225 KB)
    - 3/30/06 (PDF, 225 KB)
  - Meeting Minutes
    - 5/24/06

Related Programs and Services

Reports and Data

General Reports and Profiles
- Profile of Preventive Care for Children in Medicaid Managed Care, 2004 (PDF, 60 KB)
- Profile of Chronic Conditions in Medicaid Managed Care, 2004 (PDF, 59 KB)
- Profile of Mental Health and Substance Abuse Services in Medicaid Managed Care (MHSA), 2004 (PDF, 63 KB)
- Profile of Women’s Healthcare in Medicaid Managed Care, 2004 (PDF, 59 KB)
Enrollment Reports and Information
- Medicaid/BadgerCare Caseload Statistics
- Monthly HMO Enrollment Reports (County, HMO, and Special Programs Summaries)
- 2008 BadgerCare Plus HMO Service Area Map and Service Area Grid
  (2006 Service Area Grid [PDF, 16 KB] | 2005 Service Area Grid [PDF, 64 KB])
- SSI Medicaid Managed Care Expansion
  - Updated SSI Expansion Map, 1/7/08 (PDF, 17 KB)
Quality Reports
- 2007 External Quality Review Report (PDF, 293 KB)
- Quality Assessment and Performance Improvement Strategic Plan 2006-2008 (PDF, 78 KB)
- 2006 CAHPS^® Enrollee Satisfaction Survey Executive Summary Report
- 2004 CAHPS^® Enrollee Satisfaction Survey Executive Summary Report
- HMO Report Card
  - 2007
  - 2006
  - 2005
- Managed Care Organization Performance Improvement Studies
- Medicaid Encounter Data Driven Improvement Core Measure Set (Meddic-MS) Data Book
  - 2007 MEDDIC-MS Technical Specifications (PDF, 141 KB)
  - 2007 MEDDIC-MS SSI Technical Specifications (PDF, 101 KB)
  - 2006
    - Vol. 1 — 2006 HMO Aggregate Performance Data (PDF, 99 KB)
    - Vol. 2 — 2006 HMO-Specific Performance Data (PDF, 110 KB)
    - SSI Managed Care (PDF, 160 KB)
  - 2005
    - Vol. 1 — 2005 HMO Aggregate Performance Data (PDF, 81 KB)
    - Vol. 2 — 2005 HMO-Specific Performance Data (PDF, 107 KB)
    - SSI Managed Care — Wisconsin Independent Care (iCare) Program (PDF, 49 KB)
  - 2004
    - Vol. 1 — 2004 HMO Aggregate Performance Data (PDF, 232 KB)
    - Vol. 2 — HMO-Specific Performance Data (PDF, 236 KB)
    - SSI Managed Care — Wisconsin Independent Care (iCare) Program (PDF, 165 KB)
  - 2003
    - Vol. 1 — 2003 HMO Aggregate Performance Data (PDF, 224 KB)
    - Vol. 2 — 2003 HMO Performance Data (PDF, 178 KB)
    - Vol. 3 — 2003 HMO-Specific Performance Data (PDF, 225 KB)
    - SSI Managed Care — Wisconsin Independent Care (iCare) Program (PDF, 49 KB)
  - 2002
    - Vol. 1 — 2002 HMO Aggregate Performance Data (PDF, 263 KB)
    - Vol. 2 — 2002 HMO Performance Data (PDF, 250 KB)
    - Vol. 3 — 2002 HMO-Specific Performance Data (PDF, 357 KB)
    - SSI Managed Care — Wisconsin Independent Care (iCare) Program (PDF, 186 KB)
Historical Data
- Profile of Preventive Care for Children in Medicaid Managed Care, 2003 (PDF, 61 KB)
- Profile of Chronic Conditions in Medicaid Managed Care, 2003 (PDF, 60 KB)
- Profile of Mental Health and Substance Abuse Services in Medicaid Managed Care (MHSA), 2003 (PDF, 64 KB)
- Profile of Women’s Healthcare in Medicaid Managed Care, 2003 (PDF, 59 KB)
- Profile of Preventive Care for Children in Medicaid Managed Care, 2002 (PDF, 58 KB)
- Profile of Chronic Conditions in Medicaid Managed Care, 2002 (PDF, 59 KB)
- Profile of Mental Health and Substance Abuse Services in Medicaid Managed Care (MHSA), 2002 (PDF, 60 KB)
- Profile of Women’s Healthcare in Medicaid Managed Care, 2002 (PDF, 58 KB)
- HMO Comparison Reports — 1998-99, 1997, 1996

DHS

Wisconsin Department of Health Services

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