January 1, 2020 co-pays temporarily suspended by DHS

The Wisconsin Department of Health Services (DHS) will temporarily suspend Medicaid and BadgerCare Plus member co-pays for dates of service on and after January 1, 2020. Per federal law, members enrolled in most forms of Medicaid may not be charged premiums and co-payments that exceed five percent of their income. To ensure this requirement is met, DHS will be implementing system changes to monitor member co-pays.

While these changes are being implemented into the system, the Centers for Medicare & Medicaid Services has approved a temporary strategy in which DHS suspends member co-pays.

Beginning January 1, 2020, Medicaid-enrolled providers may not collect any co-pays for services provided to Medicaid and BadgerCare Plus members. DHS will provide an update in 2020 to give partners and providers notice in advance when providers may begin collecting co-payments again from members.

Note: The temporary suspension of co-payments does not apply for members enrolled in SeniorCare or the Wisconsin Chronic Disease Program (WCDP). SeniorCare and WCDP members will continue to be charged co-pays.

Your Revenue Cycle Management partner, ebix, Inc. thought this information would be of benefit to your organization. Our professional associations help us stay ahead of the curve, ensuring our partners are always benefiting from our growing expertise.

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