State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

36.6 Wisconsin Well Woman Medicaid Reviews/Recertifications

Reviews/recertifications are required every 12 months after the initial eligibility determination at the member’s WWWMAWisconsin Well Woman Medicaid enrollment date. A review for WWWMA only consists of receiving an updated F-10075 WWMA Determination form. There is no financial test.

 

Notices identifying the WWWMA members needing recertification are sent to the monthly. The CAPO notifies the client 45 days before a review is due, and indicates what materials or information the memberA recipient of Medicaid; formerly referred to as a "client." needs to return. The CAPO includes a blank F-10075 with the notice.  In most cases the member will only need to supply the CAPO with an updated F-10075.

 

Note: In order to eliminate unnecessary reviews, a best practice is to check interChange to be sure that the member has not become certified for BadgerCare Plus or another type of full benefit MA (for example SSISupplemental Security Income. A program based on financial need operated by the Social Security Administration that provides monthly income to low income people who are age 65 or older, blind, or disabled. MA), turned 65 years of age (or will turn 65 in the next twelve months), or become eligible for Medicare Part(s) A, B or both, prior to notifying the member that a review is due.

 

The member or her representative must send or fax the F-10075. to the CAPO via:

 

1. Email: DHSEMCAPO@dhs.wisconsin.gov,

2. Fax: (608) 267-3381, or

3. Mail :

WI DHSDepartment of Health Services - EM CAPO

1 West Wilson St.  Room 358

P.O. Box 309

Madison, WI 53701- 0309

 

At review, the member must provide a newly completed WWWMA Determination form F-10075  indicating she is still in need of treatment for breast or cervical cancer, as certified by a physician or nurse practitioner.

 

Members formerly enrolled in WWWPThe Wisconsin Well Woman Program do not need to provide a new DPH 4818 at recertification.

 

The CAPO sends a manual positive notice if all requirements are met.

 

The CAPO will send a manual negative notice at least ten days prior to the case closing if the member does not provide an updated F-10075  or if the member reports one of the changes listed in 36.5 WWMA Changes.

 

 

 

This page last updated in Release Number: 10-02

Release Date: 06/22/10

Effective Date: 09/01/09

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The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030