Section 145.13. Dispensary reimbursement.

 

(1)   Reimbursable services. Public health dispensary services reimbursable by the department shall include at least the following:

(a) Tuberculin skin testing of high-risk persons as defined by the Centers for Disease Control and Prevention. The administration and reading of a tuberculin skin test shall be considered one visit. Tuberculin skin tests administered to persons who are not defined as high–risk by the Centers for Disease Control and Prevention, such as school employees, are not reimbursable.

(b) One chest radiograph for a person with a newly identified significant skin test result, including interpretation and consultation services.

(c) One follow-up chest radiograph, including interpretation and consultation services, to document response to therapy.

(d) An initial medical evaluation and one interim medical evaluation, as needed.

(e) Blood specimen collection for one baseline and up to 3 follow-up liver function tests.

(f) Visits to collect initial diagnostic sputum specimens, either freely coughed or induced, and follow-up specimens to monitor successful treatment, up to a total of 3 initial and 6 follow-up specimens.

(g) Sputum induction for collection of up to 3 specimens for initial diagnosis and 3 for documentation of sputum conversion.

(h) Case management visits and visits to provide directly observed therapy to persons with tuberculosis disease up to a maximum of 66 visits.

(2)   Reimbursement rate.

(a) The department shall reimburse public health dispensaries on a quarterly basis for services provided under sub. (1) to clients who are not recipients of medical assistance until the biennial appropriation under s. 20.435 (1) (e) , Stats., is totally expended. Reimbursement shall be at least at the medical assistance program rate in effect at the time of the delivery of the service.

(b) Public health dispensaries may claim reimbursement from the medical assistance program under ss. 49.43 to 49.497 , Stats., and chs. DHS 101 to 108 for services under sub. (1) provided to persons eligible for medical assistance under s. 49.46 (1) (a) 15. , Stats.

History: Cr. Register, March, 2000, No. 531 , eff. 4-1-00; CR 01-105 : Cr. Register March 2002 No. 555 , eff. 4-1-02; correction in (2) (b) made under s. 13.92 (4) (b) 7. , Stats., Register January 2009 No. 637 ; correction in (2) (a) made under s. 13.92 (4) (b) 7. , Stats., Register July 2011 No. 667 .

Note

"High-risk persons" are defined in the Centers for Disease Control and Prevention report, "Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection." The report may be found in the Morbidity and Mortality Weekly Report, June 9, 2000, Vol. 49, No. RR-6, and is on file in the Legislative Reference Bureau, and is available from the Department's Division of Public Health, P.O. Box 2659, Madison, WI 53701–2659. Microsoft Windows NT 6.1.7601 Service Pack 1