PROGRAM INTEGRITY

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WMA encourages all MBs in Wisconsin to meet the following requirements:

DHS Requirement: IRIS, Self-Directed Waiver Program Integrity
The responsible spending of public dollars is generally referred to as self-directed waiver program integrity. Microboards must operate with the highest level of integrity to ensure public dollars are spent responsibly.

State Requirement: Wisconsin Non-Stock, Non-Profit 

(Chapter 181)
Any entity that conducts business transactions in the State of Wisconsin must fit into one of the legal entities as described by the State of Wisconsin. This is a State of Wisconsin requirement. Because a Microboard is to support one person with a disability and their long-term care needs, the only legal structure the Wisconsin Microboard Association will recognize is a State of Wisconsin Chapter 181 Non-Stock, Non-Profit Corporation.

Medicaid: Fraud, Waste and Abuse
Microboard principles and guidelines are ethical practices that embrace Medicaid’s definitions of Fraud, Waste and Abuse.

• Fraud: Intentional deception or misrepresentation made by a person with knowledge that the deception could result in some type of benefit to himself or some other person. 
• Waste: Healthcare spending that can be eliminated without reducing quality of care. Quality waste includes overuses, under-use and ineffective use. Ineffective use includes redundancy, delays and unnecessary process complexity. 
• Abuse: Provider practices that are inconsistent with sound fiscal, business and medical practices and result in unnecessary costs to the Medicaid program, or in reimbursement for services that are not medically necessary or fail to meet professionally recognized standards for healthcare.