Why become a provider?
- The number of children with disabilities being served through the children's state waiver program is projected to grow to over 10,000 in 2019.
- Many families are looking for local providers of services that help their children increase or maintain their daily capabilities at home, or in the community.
Learn more about how to become an approved provider. Registering is free.
Below is information for providers on program policies, procedures, initiatives, and rate information. You can also sign up for the CLTS provider email list to receive updates on provider-related information.
Claims processing
The Department of Health Services (DHS) has contracted with a third party administrator (TPA) claims processing vendor for the Children's Long-Term Support (CLTS) Waiver provider services. The DHS TPA vendor is Wisconsin Physicians Service (WPS). WPS processes and issues payments for CLTS services, collects and reports claims data, and recovers overpayments on behalf of DHS according to federal regulations.
- Third Party Administration (TPA) Claims Processing
- Wisconsin Physician Services
- CLTS Waiver Program Claim Processing—Instructional webcast
Contact information: WPS CLTS Customer Service Call Center, Monday through Friday, at 877-298-1258
Memos, guides, resources
Below is helpful information for providers.
Program policy
DHS is updating the Medicaid Home and Community-Based Services Waiver Manual for the CLTS Waiver Program to reflect the five-year renewal of the waiver, approved by the Centers for Medicare & Medicaid Services (CMS) effective April 1, 2017. The approved waiver period is effective April 1, 2017, through December 31, 2021. DHS has amended the waiver to meet the CMS requirement for DHS to implement a statewide uniform rate methodology for most CLTS waiver services.
Provider directory
DHS has recently launched a searchable online CLTS Waiver Provider Directory. It currently lists all county waiver agencies only. Future updates will display additional waiver service providers.
- The directory can be searched by provider name, type of service provided, and county.
- The directory will be fully available to the general public by summer 2019.
- When you register as a CLTS provider, your information will be included in the directory.
Provider rates
The federal Centers for Medicare & Medicaid Services (CMS) directed the State of Wisconsin to create a uniform rate-setting methodology for many CLTS waiver services as per the home and community-based service (HCBS) 1915(c) regulations. The previous practice, in which individual county waiver agencies set rates directly with providers, is no longer allowed by CMS. The new rates, P-02184 (PDF) went into effect July 1, 2019.
Provider registration
Registering with the Department of Health Services (DHS) is the first step in becoming an approved provider of CLTS waiver services. DHS requires providers to re-register every four years.
Your role in the participant's Individualized Service Plan
As a CLTS Waiver Program provider, you will have an important role in the child’s Individualized Service Plan (ISP) and you may be asked to sign the participant’s outcomes form.
You will get access to relevant information on the ISP that will help you understand the goals and outcomes a child and his or her family desires to achieve. Sharing this information with you helps promote a teamwork approach. It also expands your perspective to learn how your contribution is part of a bigger picture for each child and family.
