Choice Counseling. The provision of information and services designed to assist Members in making enrollment decisions; it includes answering questions and identifying factors to consider when choosing among Contractors and Primary Care Providers. Choice counseling does not include making recommendations for or against enrollment into a specific Contractor.
Choice Counseling. In accordance with 42 C.F.R. §438.2, choice counseling is the provision of information and services designed to assist beneficiaries in making enrollment decisions; it includes answering questions and identifying factors to consider when choosing among managed care plans and primary care providers. Choice counseling does not include making recommendations for or against enrollment into a specific MCO, PIHP, or PAHP.
Choice Counseling. A. CARES staff will provide prospective enrollees with information regarding their Medicaid long- term care options. These options may include: enrolling in the project, participating in another Medicaid home and community-based services waiver program, placement in a nursing home, or declining long-term care assistance.
B. CARES staff will also perform a choice counseling function for the project. The choice counseling function includes providing the prospective enrollee with contractor prepared, and department approved, educational materials, and explaining the following:
1. The concept of managed care and the integrated delivery of acute and long-term care.
2. The advantages to the enrollees of the integration and coordination of acute and long-term care.
3. The qualifications for enrollment in the project.
4. That the enrollee has the right to choose any available contractor in the service area and may change contractors if the enrollee is not satisfied with his/her initial choice.
5. The benefits provided under the project.
6. Pursuant to 42 CFR 438.10(g)(3), the contractor shall provide information on the contractor's physician incentive plans or on the contractor's structure and operation to any Medicaid recipient, upon request.
Choice Counseling. Enrollment Broker activities such as answering questions and providing information in an unbiased manner on available MCOs and advising potential enrollees and enrollees on what factors to consider when choosing among them.
Choice Counseling. The provision of information and services in an unbiased manner designed to assist Members in making enrollment decisions; it includes answering questions and identifying factors to consider when choosing among Health Plans and Primary Care Providers. The term does not include making recommendations for or against enrollment into a specific Health Plan. [42 C.F.R. § 438.2]
