Number
260644
Version
ORIGINAL
.Reference
Sponsor
THE CHAIR
Title
Resolution authorizing the Commissioner of Health to negotiate and enter into agreements with insurers and other third-party payers for reimbursement of services provided by the Milwaukee Health Department.
Analysis
The Milwaukee Health Department offers medical and case management services that are billable to the State of Wisconsin Medicaid plan and Medicaid HMO plans managed by private insurers, or other private insurance plans. This resolution authorizes the Commissioner of Health to enter into provider enrollment agreements required by insurance plans for claim reimbursement of eligible services. The Health Department does not currently and will not in the future bill individuals for any provided service, nor will these agreements require billing of individuals.
Body
Whereas, the City of Milwaukee Health Department provides a limited range of direct medical services at its clinic locations and elsewhere, including immunizations, sexual health screenings and treatment, tuberculosis screening and case management, home visiting, and lead hazard assessment and case management; and,
Whereas, the State of Wisconsin Medicaid plan, also known as BadgerCare, and affiliated insurers will reimburse providers for covered services when provided to individuals enrolled in a Medicaid plan; and
Whereas, the Health Department uses an electronic health record system that documents patient and client interactions and generates claims for reimbursement by insurers; and,
Whereas, reimbursement revenue from patient and client services reduces the net cost of Health Department services, and may in some instances provide additional funding for MHD programs; and,
Whereas, the Health Department maintains a policy of not billing individuals for services in almost all circumstances, even when services are not fully covered by insurance, and will maintain that policy to assure equity of access and availabili...
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