MedicaidAdministrativeHigh impact
ForwardHealth Update 2025-34: Prescribing, Referring, and Ordering Permissions UpdatedDecember 15, 2025: This Update has been revised since its original publication. Revised information appears in red text on page 1.
Wisconsin ForwardHealth·WI·Provider Update
Effective date
Dec 1, 2025
We identified it
Jun 18, 2026
Summary
Effective December 1, 2025, any Medicaid-enrolled provider acting within their scope of practice may now prescribe, refer, and order medical services and drugs - previously only physicians could do this. This significantly expands prescribing and ordering authority to nurse practitioners, physician assistants, therapists, and other qualified providers for Wisconsin Medicaid and BadgerCare Plus programs.
Action Required
Immediately: Update billing system and workflow to accept orders, referrals, and prescriptions from all Medicaid-enrolled providers acting within their scope (NPs, PAs, therapists, etc.), not just physicians. Train staff that these expanded provider types can now order diagnostic imaging, DME, home health, therapy services, and prescribe legend/OTC drugs for Medicaid patients. Ensure documentation retention compliance per Wis. Admin. Code § DHS 106.02(9) as claims may be audited and denied without proper documentation.