Family Care - Nursing Home Reimbursement Rate Setting

The Methods of Implementation for Wisconsin Medicaid Nursing Home Payment Rates (The Methods) is our rate-setting methodology, as issued by DHS, in accordance with Wis. Statutes and Federal Guidelines. It is used and updated annually by the Nursing Home Section and Bureau of Long Term Care Financing of the Division of Medicaid Services (DMS).  The Methods defines Cost Reporting, Allowable Expenses, Payment Allowances and Calculations, Special Rate Adjustments, Bedhold Billing, Labor Factors etc.

The Methods is used to set Medicaid daily payment rates, for Nursing Facilities (NF), and a smaller number of Intermediate Care facilities for Individuals with Intellectual Disabilities (ICF-IID).  It is also used as a reference for definitions and policy, for such topics as Related Party Transactions, Prudent Buyer Concept, Self-Funded Insurance, Restricted Use Beds, and many others.

 

Last Revised: March 16, 2017