(1) Cystic fibrosis treatment centers.
- (a) Condition. To be reimbursed by the program for medical care provided to program participants, a cystic fibrosis treatment center shall be certified by the national cystic fibrosis foundation and, except as provided in par. (b), shall be located in Wisconsin.
- (b) Border state treatment centers. The department may approve a treatment center in a state bordering on Wisconsin as a cystic fibrosis treatment center if the center is within 100 miles of the Wisconsin border, has a practice that includes providing services to Wisconsin residents and is certified by the national cystic fibrosis foundation. A border state cystic fibrosis treatment center is subject to the same requirements and contractual agreements as cystic fibrosis treatment centers located in Wisconsin.
- (c) Availability of a grievance mechanism for program participants. A cystic fibrosis treatment center shall have a written grievance procedure and shall provide a copy to each program participant. The cystic fibrosis treatment center may not discriminate against or take other retaliatory measures against a participant because the participant filed a grievance.
(2) Other providers.
- (a) A hospital or physician located in Wisconsin shall be deemed approved for reimbursement for treatment rendered to a program participant upon the department’s receipt of a valid claim for services rendered.
- (b) A pharmacy or a provider of home health care supplies shall be deemed approved for reimbursement for treatment-related services provided to a program participant upon the department’s receipt of a valid claim for services rendered.
History
History: Cr. Register, December, 1994, No. 468, eff. 1-1-95.