Medicaid HCBS Rate Reform
A 5% rate increase for home and community-based providers for services they provide started January 1, 2022. It applies to multiple service providers in Medicaid programs, including IRIS. Learn more about this initiative, funded through the American Rescue Plan Act.
Introducing the Adult Long-Term Care Update and ForwardHealth Portal Enhancements
The Wisconsin Department of Health Services (DHS) has published the first issue of the new Adult Long-Term Care Update (PDF). This new publication will share important information that affects service providers and other stakeholders for Wisconsin Medicaid's adult long-term care programs: IRIS, Family Care, Family Care Partnership, and PACE. In addition to the new publication, DHS is also launching enhancements to the ForwardHealth Portal to add content for adult long-term care administrators and providers. Read the Adult Long-Term Care Update 2022-01 (PDF) for more information about the new publication and enhancements coming to the ForwardHealth Portal.
Geographic Service Region (GSR) Reconfiguration
Charge 2 of the 2020-2021 Long Term Care Advisory Council (LTCAC) explored strategies to ensure Wisconsin's long-term care programs focus on the whole person, including: access, choice, high quality; collaborative relationships; efficient and cost-effective; with Wisconsin leading the nation in long-term care delivery, services, and supports. As part of this charge, the LTCAC was tasked with providing advice and guidance on the number of GSRs. For more information, see the LTCAC's GSR recommendation and the Family Care and IRIS GSR Reconfiguration Timeline, P-03225 (PDF).
Policy Manual and Work Instructions Updates
IRIS staff are revamping the IRIS Policy Manual and Work Instructions during 2022 to reflect the IRIS 1915(c) waiver that went into effect on January 1, 2021. New policies and addenda to the current manuals will be released prior to the completion of this project. These policies will be shared here as well as on the Resources and Reports webpage, under the Program Authority and Operations section.
- IRIS Remote Services Policy (PDF) Effective January 1, 2022
- Critical Incident and Immediate Reportable Reporting, P-03131 (PDF) Effective January 1, 2022
- Electronic Visit Verification in IRIS, P-03113
- Vulnerable and High Risk Participant, P-03128 (PDF) Effective January 1, 2022
- Fiscal Employer Agent (FEA) Transfers and Enrollments, P-03107 (PDF) Replaces sections 6.7 and 6.71 of the IRIS Policy Manual and section 6.31 of the IRIS Work Instructions.
- Guidelines for Assistive Technology – Service Dogs, P-03224 (PDF)
The IRIS consultant agency (ICA) and a fiscal employer agent (FEA) Scorecards are tools participants can use to help them choose an ICA and FEA. Each agency is represented in the Scorecards by star ratings evaluating customer satisfaction, in addition to more information about the ICA and FEA. You can find the Scorecards on the IRIS Participant Information page.
Electronic Visit Verification
In response to the federal 21st Century Cures Act, DHS is required to implement Electronic Visit Verification (EVV) for Medicaid-covered personal care services and home health services. DHS has created a dedicated webpage where providers can view all current EVV information. Providers are encouraged to visit the webpage frequently.
Beware of scam callers
Recently spam phone calls were made to IRIS (Include, Respect, I Self-Direct) participants and participant-hired workers. The callers sought personal information about the IRIS participant or demanded the IRIS participant make payment to avoid being arrested. The callers said they were from the IRIS program, IRIS consultant agencies, or fiscal employer agents. This is a scam.
The IRIS program takes the security and confidentiality of your personal information very seriously. Your IRIS consultant agency or fiscal employer agent may sometimes call you. However, the IRIS program or your IRIS consultant agency or fiscal employer agent will never ask you for personal or financial information over the phone. They also will never claim that your information is lost or missing or threaten you with arrest.
Be wary of unsolicited calls requesting sensitive personal or financial information. If you get a phone call from someone you do not recognize or if you are not sure if you should provide information to a caller:
- Do not provide or confirm any information to the caller and hang up.
- Write down who the caller was, what the caller wanted, and the caller’s phone number (if possible). Never return a call on the number provided to you in the unsolicited call, and do not trust that the information on your caller ID is accurate. Scammers can spoof their numbers, so it looks like they are calling from a particular organization even when they are not.
- Contact your IRIS consultant or the IRIS Call Center at 888-515-4747 as soon as possible to notify them of the call.
If you have been scammed or if you think your identity has been stolen, you may also report the call to the Federal Trade Commission.