MedicaidPrior AuthMedium impact
Medicaid Basic Training offered, Prior authorization for recipients retroactively disenrolled from Medicaid HMOs, special managed care programs, or Family Care care management organizations, The Health Care Financing Administration has a new name, What's new on the Medicaid Web site, Correction to July 2001 HIPAA inSight
Wisconsin Medicaid (ForwardHealth)·WI·Prior Authorization
Effective date
Aug 1, 2001
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid providers can now submit prior authorization requests for services provided to recipients who were retroactively disenrolled from HMOs and moved to fee-for-service status. Providers must indicate 'retroactive fee-for-service' in the PA request description along with actual service dates.
Action Required
Immediately: When submitting prior authorization requests for recipients retroactively moved from HMO to fee-for-service status, billing team must write 'retroactive fee-for-service' in the Description of Service field and include actual dates services were provided. Follow standard Medicaid fee-for-service procedures if PA is approved.