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Details

Detailed Information for : Personal Care Agency - Freestanding
Description:
Initial approval of a personal care agency to become freestanding and eligible to seek approval for Medicaid reimbursement. Approval follows the determination that the agency has met fit and qualified standards.  
License Type:
Approval  
Duration:

Until revoked or voluntary closure.

 
Fees:

$300.00

 
Prerequisites:

To attest, an agency must have been under contract with a Medicaid certified personal care provider that is a county agency, independent living center, federally-recognized American Indian tribe or band in Wisconsin or a home health agency to provide Medicaid personal care services. Agencies not meeting the above criteria, may also apply for approval without attesting. The application process would be the same.

 
Additional Information:

The Division of Quality Assurance (DQA) makes fit and qualified determination prior to the agency applying for Medicaid certification. See DQA Personal Care Agency website for additional information.

 
Wisconsin Statutes:
No statute(s) apply.  
Administrative Rules/Codes:

Medical Assistance Provider Certification (DHS 105.17) and Covered Services (DHS 107.112)

 
Other Agencies Involved:
Provisional approval allows the personal care agency to apply for Medicaid reimbursement through Wisconsin Medicaid ForwardHealth.  
Contact Information
Contact:
Division of Quality Assurance
Home Page:
E-mail :
Hours of Operation:
7:45 a.m. to 4:30 p.m., Monday through Friday  
Phone:
(608)266-2702  
Fax:
 
TTY/TDD:
(888)241-9432  
Mail Address:
PO Box 2969, Madison, WI 53701-2969  
Street Address:
1 West Wilson Street, Madison, WI 53703  
Agency Web Site:
 
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For additional assistance with business-related license, permit and registration information, visit the Wisconsin Small Business Development Center at http://www.wisconsinsbdc.org or phone them at 608-263-7680.


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