WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #689
Medicare Provider Enrollment
Some providers may become retroactively enrolled in Medicare. Providers should contact Medicare for more information about
retroactive enrollment.
Services for Dual Eligibles
As stated in Wis. Admin. Code § DHS 106.03(7), a provider is required to be enrolled in Medicare if both of the following are
true:
• They provide a Medicare Part A service to a dual eligible.
• They can be enrolled in Medicare.
If a provider can be enrolled in Medicare but chooses not to be, the provider is required to refer dual eligibles to another
Medicaid-enrolled provider who is enrolled in Medicare.
Services for Qualified Medicare Beneficiary-Only Members
Because QMB-Only (Qualified Medicare Beneficiary-Only) members receive coverage from Wisconsin Medicaid only for
services allowed by Medicare, providers who are not enrolled in Medicare are required to refer QMB-Only members to another
Medicaid-enrolled provider who is enrolled in Medicare.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
9ef028e1349317f62f80a09c45e3b98fa5a6a6322493b6fb1517b3d8eec336e6
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