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CKSN Update for March 15, 2004 |
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CKSN UPDATE for March 15, 2004 ABC for Health, Inc. IN THIS ISSUE: 1. Case Tip: Medicaid Reimbursement 2. Senator Feingold in Dane County this Wednesday 3. Good News on Prior Authorization 4. Wisconsin Wages for Direct Service Workers 5. Federal Poverty Level Increases 6. Transition Conference in April 7. Newsletters and Websites for Learning Differences 8. Washington State Adolescent Transition Resource Notebook 9. Medical Home E-Newsletter 10. HealthWatch Updates 11. Suggestions or Tip? Contact Us! 12. Happy Birthday, ABC for Health 1. CASE TIP: MEDICAID REIMBURSEMENT Q: I paid for a medical service my child received in January 2004. The doctor charged me $100 for the service. In February I received notice that my child is eligible for Katie Beckett as of December 2003. I notified the doctor's office and they billed Medicaid, but only reimbursed me $62 of the $100 I paid. If my child was Medicaid eligible why wasn't I reimbursed the full $100? A: Under Wisconsin Medicaid rules a medical provider must submit claims to Medicaid for covered services when the provider is informed that there is Medicaid coverage for the date of service. The provider is required to accept Medicaid reimbursement as payment in full. The exception is when the provider is notified of retroactive eligibility. Once the provider receives payment from Medicaid, s/he is only required to reimburse you the amount Medicaid paid. Medicaid reimbursement rates are commonly less than a provider's usual charges. If you are waiting for notification on Medicaid retroactive eligibility it is best to notify the provider, ask for time to receive the notice of decision regarding your Medicaid application, or make a partial payment on the bill until you are notified of your child's Medicaid eligibility. (Citation: Wis. Admin. Code HFS 106.04(3)(b) 2. SENATOR FEINGOLD IN DANE COUNTY THIS WEDNESDAY U.S. Senator Russ Feingold will hold a Listening Session in Dane County on Wednesday, March 17, 2004. Senator Feingold has pledged to hold Listening Sessions in all of Wisconsin's 72 counties each year of his six-year term. His Dane County Listening Session will be held at 9:45 a.m. at Flynn Hall, 116 West Reynolds Street, Cottage Grove. This session will last up to an hour. It allows you the opportunity to express your views to the Senator on federal issues such as IDEA, MiCASA, Family Opportunity Act, Rehabilitation Act, housing, health care, voting and campaign finance reform. For more information on federal issues, check the DAWN website on national disability issues at: http://www.dawninfo.org/advocacy/national.cfm 3. GOOD NEWS ON PRIOR AUTHORIZATION DHFS published a Final Update on changes in prior authorization that improve flexibility, duration, and coordination of Medicaid therapy services for children with disabilities. For all the details go to: http://www.dawninfo.org/advocacy/issues/medicaid.cfm 4. WISCONSIN WAGES FOR DIRECT SERVICE WORKERS How do wages paid to Wisconsin direct service workers compare to other states? A February 2004 article incorporates data from WCDD's 2003 wage study into findings from an earlier national study. The new article compares Wisconsin direct service wages to wages paid in other states. DAWN Workforce Page: http://www.dawninfo.org/advocacy/issues/direct_work_short.cfm February Wage Study Article (PDF) http://www.wcdd.org/articles/Wage_Benefits_compare.pdf 5. FEDERAL POVERTY LEVEL INCREASES The Federal Poverty Level increased on February 13, 2004. Wisconsin has increased the Medicaid income eligibility limits, effective March 1, 2004. The increase is about 2 1/2 % above last year's eligibility limits. Before this year's increase, the Medicaid income eligibility limit for a family of four was $2,836 per month. After March 1, 2004, the income eligibility limit has increased to $2,906. Please be advised that these figures represent only a few of the Medicaid programs. Many methods of calculating income and other income eligibility limits apply within the entire Wisconsin Medicaid Program. For more information, visit: http://dhfs.wisconsin.gov/medicaid1/fpl/fpl.htm 6. TRANSITION CONFERENCE IN APRIL Transition: Reaching for Tomorrow Moving from Pediatric to Adult Care and Services for Youth with Special Needs Saturday, April 24, 2004, 9:00 am to 2:30 pm, Italian Conference Center, 631 East Chicago Street, Milwaukee, WI 53202-5916. Free to youth, families and professionals What you'll learn.... Strategies and tips to help meet the transition needs of youth in the areas of: * Education * Health care * Community resources, such as housing, employment, day programs, etc. Important questions to ask professionals and community resources as you go through the process of transition. How youth with special needs have traveled the road of transition, their challenges and successes. Their stories will be shared during the youth panel. Transition-related information from a variety of community agencies at the resource exhibits. For more information about this conference, see the brochure at: http://www.waisman.wisc.edu/hrtw/TRANSITIONS.PDF Or contact : About registration: Linda Oleson 414-266-2209 About conference content: Julie Turkoske 414-266-3188 This conference is co-sponsored by: *Healthy and Ready To Work, Waisman Center, University of Wisconsin Madison *Special Needs Family Center (Southeast Regional Children with Special Health Care Needs Center) *Social Work Program of Children's Hospital of Wisconsin. 7. NEWSLETTERS AND WEBSITES FOR LEARNING DIFFERENCES These suggestions have been forward to us from Robin Mathea, Parent Program Director at the Northern CSHCN Center in Rhinelander as good resources for learning differences and mental health concerns: Schwab Learning: www.schwablearning.com All Kinds of Minds: www.allkindsofminds.org 8. WASHINGTON STATE ADOLESCENT TRANSITION RESOURCE NOTEBOOK "Working Together for Successful Transition: Washington State Adolescent Transition Resource Notebook" is available online on the Adolescent Health Transition Project website: http://depts.washington.edu/healthtr/ From the homepage, click on the notebook in the red "What's New" box. The notebook may be downloaded in its entirety or one document at a time. The purpose of the notebook is to serve as a resource on transition for schools, communities, agencies, families, students, health care providers and others in Washington State. However, many of the documents are useful for others outside of WA State. 9. MEDICAL HOME E-NEWSLETTER An E-newsletter dedicated to providing medical home info and resources for children with special needs. Visit: http://www.medicalhomeinfo.org/weblinks/announce.html 10. HEALTHWATCH UPDATES There is a CHASE training in Milwaukee sponsored by the Southeastern CSHCN Center on Thursday, March 18 from 6:30 to 7:30 pm at the Aurora Family Services at 3200 West Highland Blvd in Milwaukee. The training topic is "Understanding the Medicaid Deductible and the FFU" and is preceded by a CHASE HealthWatch meeting from 5 - 6 pm and a light supper from 6- 6:30 pm. For more information, please contact Brad Montgomery (contact information below). If you are interested in joining your regional HealthWatch committee, or want more information about their work, please contact the following people: Southern Region: Barbara Katz, ABC for Health, Inc., 608.261.6939 ext 207, barbk@safetyweb.org Southeastern Region: Brad Holman, Children's Hospital of Wisconsin, 414.266.3189, bholman@chw.org or Brad Montgomery, 414.449.4777, opwindows@aol.com Northern Region: Deb Blackstone, Family Resource Connection, 715.365.8030, dblacks@shsmh.org Northeastern Region: Steve Gerczak, St. Vincent Hospital, 920.433.8154, sgerczak@stvgb.org Western Region: Rose Marsh, Chippewa County Dept of Public Health, 1-800-400-3678, rmarsh@co.chippewa.wi.us 11. SUGGESTIONS OR TIPS FOR THE UPDATE? CONTACT US! We need your help to develop content and tips for our CKSN Update. Please let us know about your ideas or success stories. Email your suggestions to barbk@safetyweb.org The CKSN Update is a bi-weekly electronic newsletter of the Covering Kids with Special Needs project that ABC for Health, Inc. is implementing with its partners, the Title V Children with Special Needs Regional Centers and Family Voices - Wisconsin. If you would like to submit news and information in future CKSN Updates, please send it to the attention of Barbara Katz. All submissions should be limited to 150 words. ABC for Health is a Wisconsin-based, nonprofit public interest law firm dedicated to linking children and families, particularly those with special health care needs, to health care benefits and services. ABC for Health's mission is to provide information, advocacy tools, legal services and expert support needed to obtain, maintain and finance health care coverage and services. 12. ABC FOR HEALTH IS TEN YEARS OLD! Save the date! ABC for Health will celebrate 10 years of advocacy and legal services on Thursday evening October 14, at the Great Hall of the Memorial Union in Madison Please consider joining us to celebrate our 10th anniversary as Wisconsin's premier public interest law firm dedicated to helping families secure adequate health care coverage and services! Watch for more information on this event in the near future. Thanks so much for your ongoing support. Barbara Katz, moderator Parent Consultant ABC for Health, Inc. 608.261.6939 ext. 207 barbk@safetyweb.org