MedicaidAdministrativeLow impact
ForwardHealth Update 2025-40: Expanding Tribal Federally Qualified Health Center Shared Savings
Wisconsin ForwardHealth·WI·Provider Update
We identified it
Jun 18, 2026
Summary
ForwardHealth is implementing a new Tribal Shared Savings program that allows outside providers with signed care coordination agreements with Tribal FQHCs to receive 100% Federal Medical Assistance Percentage (FMAP) for services to Native American/Alaska Native Medicaid members. Providers must include the Tribal FQHC's National Provider Identifier or Medicaid Provider ID in the Referring Provider or Referral Number fields when submitting claims.
Action Required
Immediately: Billing team must update claim submission procedures to include Tribal FQHC's National Provider Identifier or Medicaid Provider ID in the Referring Provider or Referral Number fields when billing for Native American/Alaska Native Medicaid members referred by Tribal FQHCs with signed care coordination agreements. Ensure documentation retention requirements per Wis. Admin. Code § DHS 106.02(9) are followed for all claims.