MedicaidAdministrativeHigh impact
New Requirements for Prescribing/Referring/Ordering Providers Due to the Affordable Care Act
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jul 15, 2013
We identified it
Jun 20, 2026
Summary
Beginning July 15, 2013, all physicians and other professionals who prescribe, refer, or order services for Wisconsin Medicaid/BadgerCare Plus members must be enrolled in Wisconsin Medicaid. Claims and prior authorization requests will be denied if they don't include the NPI of a Medicaid-enrolled provider.
Action Required
By July 15, 2013: All providers who prescribe, refer, or order services for Wisconsin Medicaid/BadgerCare Plus members must enroll in Wisconsin Medicaid (limited enrollment available starting June 14, 2013). Billing team must ensure all prior authorization requests and claims include the NPI of a Medicaid-enrolled provider. Claims without enrolled provider NPIs will be denied.