DHS has posted updated Methods of Implementation for Nursing Homes for state fiscal year 2024 on the FowardHealth Portal. The Methods include the updated process and timelines for auditing nursing home cost reports and setting nursing home rates previously shared at the July 24, 2023, public meeting.

Please note the following requirements for reviewing, accepting, and contesting issued nursing home reimbursement rates:

• Review
  • Upon completion of the nursing provider’s cost report audit, the auditor notifies the provider of their rates via the Wisconsin Nursing Home Reporting System (WINHRS).
  • The provider will have 15 days from notification to review their rates and mark in WINHRS that they will either be accepting their rates or that they wish to contest the audit adjustments.
• Accept
  • A provider may accept their rates at any time within the initial 15-day timeframe if they are not contesting audit adjustments. Once a provider accepts their rates, the auditor will finalize those rates with ForwardHealth. The rates will then be posted to the ForwardHealth Portal, accessible on a provider’s account.
  • If a provider does not respond within the 15-day timeframe, the auditor will finalize those rates with ForwardHealth. The rates will then be posted to the ForwardHealth Portal, accessible on a provider’s account.
• Contest
  • If the provider marks in WINHRS that they wish to contest an adjustment within the 15-day timeframe, then the provider will have 30 days from the time that they were notified of their initial rates in WINHRS to send additional documentation.
  • To contest an adjustment, the provider must upload to WINHRS any additional documentation and support for the amounts being contested no more than 30 days after and including the date of the initial rate notification.

If the provider has not uploaded documentation to substantiate their contesting of the audit adjustments by the end of the 30 days, the auditor will finalize the provider’s rates with ForwardHealth. The rates will then be posted to the ForwardHealth Portal, accessible on a provider’s account.

Please contact Kate Dickson with any questions.