Programs or Services
Division of Health Care Access and Accountability
The Division provides access to health care for low income and medically needy
persons. It also provides health care information to assist consumers in decisions on health care
providers and health care plans.
Medicaid. Pays for health related services to low-income and medically needy
persons. These include services provided by nursing homes; and fee-for-service and managed
care health care providers.
Health Care Systems and Operations. Implements,
operates and monitors program operations, systems, procedures and contracts.
payment for services with other funding sources and recovers payments from the estates of
recipients, where appropriate.
Health Care Eligibility Determination. Develops and implements eligibility
policies for the Divisions health care programs, works with counties and tribes to
determine eligibility, and provides outreach to citizens about value of health care
services and the eligibility rules.
Health Care Program Integrity. Develops and implements prior authorization
guidelines, performs audits of service providers, and develops quality control measures
Fee-for-Service Health Care Benefits. Develops reimbursement rates for direct
medical and policy services and programs. Manages the entire Medicaid budget.
Medicaid statutory changes, administrative rule updates, and federal state plan changes.
Reviews and audits nursing home costs.
Managed Health Care. Develops and administers all Medicaid Managed Care
Programs for Medicaid recipients, AFDC-related and BadgerCare low-income families with
children, disabled children and adults and low-income elderly.
Disability Determination Services. Provides disability and blindness
eligibility determinations under contract with the Social Security Administration for
individuals who apply for Supplemental Security Income, Medicaid or Social Security
Return to DHCAA
Last Revised: July 12, 2010