Common use of Case Management Clause in Contracts

Case Management. In accordance with 42 C.F.R §440.169, case management services means services furnished to assist individuals, eligible under the State plan who reside in a community setting or are transitioning to a community setting, in gaining access to needed medical, social, educational, and other services, in accordance with §441.18 of this chapter. As with care management, case management activities also emphasize prevention, continuity of care, and coordination of care. Case management activities are driven by quality-based outcomes such as: improved/maintained functional status; enhanced quality of life; increased member satisfaction; adherence to the care plan; improved member safety; and to the extent possible, increased member self-direction.

Case Management. is amended by DELETING the definition in its entirety and REPLACING with the following, “In accordance with 42 C.F.R §§ 440.169, case management services means services furnished to assist individuals, eligible under the State plan who reside in a community setting or are transitioning to a community setting, in gaining access to needed medical, social, educational, and other services, in accordance with §§ 441.18 of this chapter. As with care management, case management activities also emphasize prevention, continuity of care, and coordination of care. Case management activities are driven by quality-quality- based outcomes such as: improved/maintained functional status; enhanced quality of life; increased member satisfaction; adherence to the care plan; improved member safety; and to the extent possible, increased member self-direction.”