Waivers and Variances: Adult Day Care Center, Hospitals, Hospices, Home Health Agencies, or Personal Care Agencies

Use the following procedure to request a waiver or variance of a Wisconsin state statute or administrative code. This information applies to:

• Adult Day Care Center
• Hospitals.
• Hospices.
• Home health agencies.
• Personal care agencies.

Requirements

Wisconsin administrative code requirements for a waiver or variance:

• Adult Day Care Center: Wis. Admin. Code § DHS 105.14(1)(c)4.c
• Hospitals: Wis. Admin. Code § DHS 124.04
• Hospices: Wis. Admin. Code § DHS 131.16
• Home health agencies: Wis. Admin. Code § DHS 133.04(6)
• Personal care agencies: Wis. Admin. Code § DHS 106.13

Definitions

• Waiver means an exception from a requirement identified in the applicable chapter of the Wisconsin administrative code.
• Variance means an alternative requirement in place of a requirement identified in the applicable chapter of the Wisconsin administrative code.

Submit a request

Complete the Waiver or Variance Request, F-02527 (Word). Make all waiver or variance applications in writing to the Wisconsin Department of Health Services (DHS), and specify the following:

• The rule from which the waiver or variance is requested. Find codes for:
  • Adult Day Care Center: Wis. Admin. Code § DHS 105.14(1)(c)4.c
  • Hospitals: Wis. Admin. Code ch. DHS 124
  • Hospices: Wis. Admin. Code ch. DHS 131
  • Home health agencies: Wis. Admin. Code ch. DHS 133
  • Personal care agencies: Wis. Admin. Code § DHS 105.17
• The time period requested. (Indicate temporary or permanent. If temporary, give an estimated end date.)
• For a variance, the proposed alternative action.
• The reasons for the request.
• How the waiver or variance will not adversely impact the health, safety, or welfare of a patient, client, or resident.

Submit the completed request form by:

• Mail:
  DHS Bureau of Health Services
  Attn: BHS Director
  PO Box 2969
  Madison, WI 53701-2969
• Email dhsdqalccs@dhs.wisconsin.gov
• Fax 608-264-9847

Approval or denial process

Here's how DHS will let you know if your request was approved or denied.

Adult Day Care Center

The department may terminate approval of a waiver or variance if any of the following occurs:

1. The department determines the waiver or variance has adversely affected the health, safety, well-being or welfare of a participant.
2. The ADCC fails to comply with any of the conditions of the waiver or variance as granted.
3. A change in circumstances from the time the waiver or variance approval was initially granted. Wis. Admin. Code § DHS 105.14(1)(c)4.c
4. The ADCC failed to disclose a fact that is material to the approval.

Hospitals

• We will let you know in writing if your request was approved or denied. If we deny a request, we'll let you know why.
• We may modify the terms of a requested variance upon agreement with the hospital.
• We may impose any conditions on the approval of a waiver or variance if necessary.
• We may limit the duration of any waiver or variance.

Hospices

• We will let you know in writing if your request was approved or denied. If we deny a request, we'll let you know why.
• We will automatically approve a waiver or variance if we don't issue a notice of denial within 60 days after we receive a complete request.
• We may modify the terms of a requested variance upon agreement with the hospice.
• We may impose conditions on the approval of a waiver or variance if necessary.
• We may limit the duration of a waiver or variance.

Home health agencies

We will let you know in writing if your request was approved or denied. If we deny a request, we'll let you know why.

For waivers or variances submitted by a home health agency, we may waive or vary any provision of Wis. Admin. Code ch. DHS 133 if we find that the waiver or variance will not adversely affect the health, safety, or welfare of any patient.

Personal care agencies

• We will let you know in writing if your request was approved or denied. If we deny a request, we'll let you know why.
• We may modify the terms of a requested variance at any time.
• We may impose conditions on the approval of a waiver or variance if necessary.
• We may limit the duration of a waiver or variance.
• We may revoke a discretionary waiver or variance at any time if we determine that there is evidence of fraud or Medicaid program abuse by the provider or recipient; or if any of the facts upon which the waiver or variance was originally based are no longer true.

Additional resources

Find more provider-specific regulatory and contact information:

• Adult Day Care Center
• Hospitals
• Hospices
• Home Health Agencies
• Personal Care Agencies