As required under Section 1902 of the Social Security
Act (Act), the Plan was developed by our state and approved by the
United States Department of Health & Human Services.
The entity within the Department of Health and Human Services which
reviews state plan documents is the Center for Medicare and Medicaid
Services (CMS). Without a State Plan, Wisconsin would not be eligible for federal
funding for providing Medicaid services. Essentially, the Plan is our
state's agreement that it will conform to the requirements of the Act
and the official issuances of CMS. The State Plan includes the many
provisions required by the Act, such as:
Once the original Plan has been approved by CMS, all
future changes to the Plan must also be approved by CMS before they
can
become effective. Plan changes are submitted by the state to CMS as
State Plan Amendments. CMS reviews each
State Plan Amendment to determine whether it
meets federal requirements and policies. The Plan is updated when
CMS issues final approval of a
State Plan Amendment. A state can also ask CMS to waive
certain federal requirements to allow it greater flexibility to
institute such programs as primary care case management systems, and
home and community-based services in lieu of
institutionalization.
By law, a state's request to CMS to approve a
proposed State Plan, a
State Plan Amendment, or a waiver of a requirement, must be
approved, disapproved, or additional information requested within 90
days of receipt. Otherwise, the request is considered to be
approved.
The Plan on this website is for informational purposes
only and is not legally binding. The official Plan is maintained by
CMS Region V. The files on these pages are available as read-only in
Word and in Portable Document Format (PDF), which requires the use of
Adobe Acrobat Reader. The Adobe Acrobat Reader is necessary for the
user to be able to read a PDF.
