WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #407
Emergencies
Non-network providers may provide services to BadgerCare Plus HMO and Medicaid SSI HMO enrollees in an emergency
without authorization or in urgent situations when authorized by the HMO or SSI HMO. The contract between Wisconsin DHS
(Department of Health Services) and the HMO or SSI HMO defines an emergency situation and includes general payment
requirements.
Unless the HMO or SSI HMO has a written agreement with the non-network provider, the HMO or SSI HMO is only liable to
the extent fee-for-service would be liable for an emergency situation, as defined in 42 C.F.R. § 438.114. Billing procedures for
emergencies may vary depending on the HMO or SSI HMO. For specific billing instructions, non-network providers should
always contact the enrollee's HMO or SSI HMO.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
a506fb8aeced1947dfdca38a053864e8f2454de254e2142902562b081a36add5
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