Traditional MedicareAdministrativeHigh impact
Medicare Enrollment Requirement
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jun 1, 2005
We identified it
Jun 20, 2026
Summary
Wisconsin providers serving dual-eligible patients (those with both Medicare and Medicaid) must now enroll in Medicare if they provide Medicare Part B-covered services and are eligible to enroll. Providers who choose not to enroll must refer these patients to Medicare-enrolled providers.
Action Required
Immediately: Wisconsin providers must verify Medicare enrollment status if treating dual-eligible patients. If providing Medicare Part B services to dual eligibles and not enrolled in Medicare, either complete Medicare enrollment or establish referral protocols to Medicare-enrolled providers. Billing team must update patient eligibility verification to identify dual eligibles and confirm provider Medicare enrollment before scheduling services.