MedicaidAdministrativeHigh impact
BadgerCare Plus HMO Expansion
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
May 1, 2008
We identified it
Jun 20, 2026
Summary
BadgerCare Plus is expanding HMO coverage to 10 Wisconsin counties starting May 2008, making HMO enrollment mandatory for Standard and Benchmark Plan members. Providers must verify HMO enrollment before services or claims will be denied for HMO-covered services submitted to fee-for-service.
Action Required
Before May 2008: Billing team must implement HMO enrollment verification for all BadgerCare Plus members in Columbia, Dane, Dodge, Grant, Green, Iowa, Jefferson, Lafayette, Rock, and Sauk counties before providing services. Update front desk procedures to check member HMO status. Claims for HMO-covered services submitted to fee-for-service will be denied. Contact HMOs directly to join provider networks if interested in serving HMO members.