Assembly Bill 1225 aims to reform the Medical Assistance program in Wisconsin by prohibiting the Department of Health Services (DHS) from entering into or renewing contracts with managed care organizations for Medical Assistance. Instead, the bill mandates that DHS pay providers directly on a fee-for-service basis. The bill also allows for the continuation of contracts with counties that operate managed care organizations for specific programs, such as Family Care and PACE. Additionally, it requires DHS to maintain a statewide network of Medical Assistance providers and to establish a call center and website to assist recipients in finding healthcare providers.

The bill introduces several new provisions, including the creation of community primary care and outreach grants, which will fund hiring community health workers and provide care coordination services. It also establishes requirements for timely and equitable service provision to Medical Assistance recipients and emphasizes the recruitment of culturally competent healthcare providers. Furthermore, the bill includes provisions for increasing reimbursement rates for services in high-demand areas and mandates collaboration with healthcare providers to improve care quality and reduce costs. Overall, the bill seeks to enhance the accessibility and quality of healthcare services for Medical Assistance recipients in Wisconsin.

Statutes affected:
Bill Text: 49.45(2)(b)2, 49.45, 49.45(3)(c)