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MedicaidAdministrativeMedium impact

Family Care and IRIS Coming to Northeast Wisconsin

Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jun 1, 2015
We identified it
Jun 20, 2026
Days to comply

Summary

Family Care and IRIS long-term care programs are expanding to northeast Wisconsin counties starting June 2015, with staggered rollout dates through November 2015. Providers must join MCO networks and obtain prior authorization before providing Family Care services, while IRIS allows direct provider selection by participants.

Action Required

Action needed
By June 1, 2015: Providers serving Kewaunee and Oconto counties (and subsequent counties through November 2015) must enroll in Care Wisconsin or Lakeland Care District MCO networks to serve Family Care members. Always verify member enrollment before providing services using WiCall at (800) 947-3544 or ForwardHealth Portal, as members can enroll/disenroll at any time during the month. Obtain MCO authorization before providing any Family Care services to avoid claim denials.