Development of Care Plan. The Parties’ subcontract shall require that the CP develop a Care Plan as described in Section 2.5.B.5 of the Contract. The CP shall utilize a Care Plan template approved by the Contractor that meets the requirements of Section 2.5.B.5 of the Contract. In addition to the requirements in Section 2.5.B.5, the Parties’ subcontract shall require the following:
1. Care Plans shall be reviewed by a registered nurse (RN) employed by the CP. Care Plans shall receive final review and approval by a Clinical Care Manager employed by the CP.
2. The CP shall document within the Enrollee record that the Care Plan was provided to, agreed to, and signed or otherwise approved by the Enrollee.
3. The CP shall complete Care Plans within five (5) calendar months of Enrollee’s enrollment with the CP. A Care Plan shall be considered complete when:
a. The Care Plan has been signed or otherwise approved by the Enrollee; and
b. The Care Plan has been shared with the Enrollee’s PCP or PCP Designee.
4. The CP shall share the completed Care Plan with the Contractor and other parties who need the Care Plan in connection with their treatment of the Enrollee, provision of coverage or benefits to the Enrollee, or related operational activities involving the Enrollee, including members of the Enrollee’s Care Team, CBHC staff, if applicable, and other providers who serve the Enrollee, including state agency or other case managers, in accordance with all data privacy and data security provisions applicable.
Development of Care Plan. The Parties’ subcontract shall require that the CP develop a Care Plan as described in Section
