- AGNESIAN CONTRACT-5.25.21-executed.pdf

This is a medical services contract between the Wisconsin Department of Corrections and Agnesian Healthcare, Inc., effective July 1, 2021, through June 30, 2022, with five possible one-year renewal options upon mutual agreement. The contract number is 410008-W22-ELB8256-GEN-01, and it includes supplemental agreements for substance use disorder records handling and various administrative requirements through the DOC Rider provisions.

The contract provides comprehensive medical services to Persons in Our Care (PIOC) within the Wisconsin correctional system, including inpatient, outpatient, and emergency services. Agnesian Healthcare will be reimbursed using multiple payment structures: facility inpatient services at Medicaid rates (190% in CY 2021, escalating to 193% by CY 2026), facility outpatient services at current Medicare Ambulatory Payment Classification rates (190-193% depending on contract year), professional services at 225% of Medicare rates for non-facility services, and laboratory services at 135% of Medicare Part B rates. The contract includes specialized provisions for skilled nursing facility swing bed services paid at National Services Government rates, with surgical procedures receiving additional facility outpatient reimbursement rates when performed during swing bed status. Payment terms require submission within 183 days of service, with DOC paying within 30 days of receiving clean claims, and include provisions for appeals, refunds, and audit requirements.