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State of Wisconsin |
Release 26-02 |
Income changes which are reported timely and result in an increased patient liability or cost share have the following effective dates:
Do not complete F-10110 (formerly DES 3070) for retroactive patient liability or cost share increases since the member must receive timely notice. This includes scenarios in which a member is switching from a patient liability to a cost share or from a cost share to a patient liability.
Decreases in patient liability or cost share are always effective the first of the month in which the decrease in income occurs or the decrease is reported, whichever is later.
Liability changes must be reviewed when coverage was maintained following a reported change or a timely renewal. Once eligibility is able to be redetermined, liability amounts for months with coverage maintained may need to be reduced. See PH 11.11.1.2 Restoration of Benefits for Institutional Medicaid.
| Note | If an Administrative Law Judge or court orders a decreased liability or cost share, the agency must follow the court order and apply changes retroactively as stated in the court order. |
This page last updated in Release Number: 25-04
Release Date: 12/10/2025
Effective Date: 12/10/2025
The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10030