Questions and Answers

Q & A Topics

General | Billing and Payment | Chronic Illness Demonstration Project (CIDP) | Health Home Design | Health Home Development Funds | Health Home Letter of Intent/Applications/Provider Enrollment/Application Form | Health Home Network | Health Information Technology | Managed Care | Member Forms | Population Assignment/ Eligibility (Patient Tracking System) | Quality Metrics and Evaluation (CMART) | Spend Down | Targeted Case Management (TCM) |

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Managed Care

1. If individuals are to have choice of both Health Homes and MCOs in their area, are Health Homes required to be a network provider with all Managed Care Plans in their area?

There is no requirement that MCOs have ASA's with all Health Homes or vice versa, although this is strongly encouraged. The State is obligated to provide members with a choice of Health Home as practicable which is being accomplished by designating more than one Health Home in each region. In addition, members have a choice of care managers in their Health Home.

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2. How can Health Homes obtain contact information for MCOs?

You may access a list of contacts for each of the MCOs and the counties that they serve by clicking here.

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3. In a plan specific agreement with a Managed Care Plan, can performance be included such as documentation, number of services to be delivered, number of contacts, etc.?

No. These requirements cannot be imposed on Health Homes and should not be included in the agreement or any appendices.

For information related to Managed Care go to the Managed Care webpage by clicking here.

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