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State of Wisconsin Release 20-04 November 23, 2020 |
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State of Wisconsin Release 20-04 November 23, 2020 |
21.7.1 ForwardHealth Cards Introduction
21.7.3 Pharmacy Services Lock-in Program
ForwardHealth cards are issued to Medicaid members. These cards are permanent, plastic, and display the word "ForwardHealth” on them. Members use the same ForwardHealth card each month. Monthly cards are not issued.
The cards do not display eligibility dates. Health care providers use the ID number on the front of the card to bill for services provided to the member.
Cards should not be thrown away. If a member becomes eligible again, he or she will use the same ForwardHealth card originally issued. If members have questions regarding their eligibility status, they can log into ACCESS or call Member Services at 1-800-362-3002.
BadgerCare Plus and Medicaid
SeniorCare
Each person in the family who is eligible for Medicaid receives his or her own card. The cards do not display eligibility dates. All Medicaid services are paid for under the Medicaid ID number on the card.
Members will know if they are eligible based on positive and negative notices sent from the IM agency. Members who receive a notice that they are no longer eligible for Medicaid should keep their ForwardHealth cards. Cards should not be thrown away. If a member becomes eligible again,he or she will use the same ForwardHealth card originally issued. If members have questions regarding their eligibility status, they can call you or Member Services at 1-800-362-3002.
Make ID cards available to homeless Medicaid members who have no fixed address or mailing address. Use your agency address or some other fixed address for delivery.
A program called Pharmacy Services Lock-In is available in cases of benefit misuse. Members enrolled in the Pharmacy Services Lock-In Program are assigned to one primary care provider and one pharmacy to reduce unnecessary physician and pharmacy utilization and to discourage the non-medical or excessive use of prescription drugs. The Pharmacy Services Lock-In Program applies to members in fee-for-service as well as members enrolled in Medicaid SSI HMOs and BadgerCare Plus HMOs. Members remain enrolled in the Pharmacy Services Lock-In Program for two years and are continuously monitored for their prescription drug usage. At the end of the two-year enrollment period, an assessment is made to determine if the member should continue enrollment in the Pharmacy Services Lock-In Program.
The Pharmacy Services Lock-In Program monitors claims for pharmacy services and prescription drugs specifically. The Pharmacy Services Lock-In Program does not address other types of member fraud or misuse of benefits, such as misuse of the ForwardHealth card or excessive use of emergency room services.
If a provider suspects that a member is abusing his or her benefits or misusing his or her ForwardHealth card, providers are required to notify ForwardHealth by calling Provider Services at 800-947-9627 or by writing to:
Division of Medicaid Services
Bureau of Benefits Management
P.O. Box 309
Madison, WI 53701-0309
With implementation of the ForwardHealth ID card, temporary ID cards are no longer used or available for ordering from the fiscal agent.
If a member needs a replacement card, he or she or an authorized representative, can request a replacement card by:
Going to ACCESS
Create a MyACCESS Account, then
Go to your MyACCESS Page and select a new ForwardHealth card, or
Contacting Member Services at 1-800-362-3002.
Workers may also log into the Partner Portal and select "Replacement ID Card Request” under the Quick Links on the right side of the page.
If the member has multiple benefit ID cards, there will be a choice of which ID card to request. A new ForwardHealth card will be created the evening of the request and will be sent out the following business day.
Replacement cards are issued automatically when the card has been returned as undeliverable and the member’s address changes.
You cannot request replacement cards using F-10110 (formerly DES 3070) or CARES.
This page last updated in Release Number: 18-01
Release Date: 04/13/2018
Effective Date: 04/13/2018
