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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
Reviews/recertifications are required every 12 months after the initial eligibility determination at the member’s WWWMA 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 EM CAPO monthly. The EM CAPO notifies the member 45 days before a review is due, and indicates what materials or information the member needs to return. The EM CAPO includes a blank F-10075 with the notice. In most cases the member will only need to supply the EM 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 SSI 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 EM CAPO via:
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 WWWP do not need to provide a new DPH 4818 at recertification.
The EM CAPO sends a manual positive notice if all requirements are met.
The EM 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 Changes.
This page last updated in Release Number: 16-01
Release Date: 06/10/2016
Effective Date: 06/10/2016
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