MedicaidAdministrativeMedium impact
Supplemental Security Income Managed Care Program Expansion
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jan 1, 2007
We identified it
Jun 20, 2026
Summary
Wisconsin is expanding its SSI managed care program to 8 additional counties in early 2007. SSI recipients and SSI-related Medicaid recipients in these counties will be enrolled in HMOs, requiring providers to verify enrollment status and obtain referrals from HMOs after the initial 60-day period to ensure payment.
Action Required
By January 1, 2007: Billing team must verify SSI recipient enrollment status before providing services to determine if patient is enrolled in an HMO. After patient's first 60 days of HMO enrollment, contact the recipient's HMO for referral authorization before providing services or claims may not be reimbursed. Update eligibility verification workflow to check HMO enrollment status.