Collaboration with Other Programs. (A) If an Enrollee With Special Health Care Needs is enrolled in a Health Plan and/or a Prepaid Mental Health Plan or is enrolled in any of the Medicaid home and community-based waiver programs and is receiving case management services through that program, or is covered by one of the other Medicaid targeted case management programs, the Contractor’s care coordinator shall collaborate with the appropriate program person for that program. The Contractor shall share with other Health Plans and/or Prepaid Mental Health Plans contracted with the Department who are serving Enrollees with Special Health Care Needs the results of its identification and assessment of each Enrollee’s needs to prevent duplication of activities. (B) The Contractor shall coordinate health care needs for Enrollees with Special Health Care Needs with Enrollee’s families, caregivers, and advocates. (C) The Contractor shall coordinate health care needs for Enrollees with Special Health Care Needs with the services of other agencies such as mental and substance abuse, public health departments, transportation, home and community based care, developmental disabilities, Title V, local schools, IDEA programs, child welfare, and with families, caregivers, and advocates.
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Samples: McNa Dental Contract, Premier Access Contract Prepaid Ambulatory Health Plan (Pahp), Prepaid Ambulatory Health Plan (Pahp) Contract