HealthCheck Sample Clauses

HealthCheck. Policies on the use of emergency and urgent care facilities.
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HealthCheck. HealthCheck is a preventive health checkup program for members under the age of 21. The HealthCheck program covers complete health checkups. These checkups are very important for children’s health. Your child may look and feel well, yet may have a health problem. Your doctor wants to see your children for regular checkups, not just when they are sick. The HealthCheck health program has three purposes:
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HealthCheck. HealthCheck, a federally mandated benefit, is key to ensuring that children receive the preventive and follow up care they need, including appropriate dental, mental health, developmental, and specialty care. To the maximum extent possible, the PIHP must make every effort to ensure that HealthCheck exams are provided by primary care providers who understand the concept of trauma- informed care and who provide services based on this understanding and approach. 1. The PIHP must provide comprehensive HealthCheck screens following the enhanced periodicity schedule recommended by the American Academy of Pediatrics (AAP) for children in out-of-home care: a. Every month for the first six months of age; b. Every 3 months from 6 months to 2 years of age; c. Twice a year after 2 years of age. The PIHP must schedule interperiodic visits when medically necessary. Interperiodic visits are follow up appointments that occur between the regularly scheduled comprehensive screens. These appointments may be necessary to follow up on a condition or need identified during the comprehensive HealthCheck screen. 2. The PIHP must provide the comprehensive initial health exam within 30 days of enrollment. This exam must meet HealthCheck requirements and must be performed according to AAP guidelines for children in out-of-home care (see Addendum II). Subsequent comprehensive HealthCheck exams must consist of, at a minimum, reassessments of the member’s health, development and emotional status to determine the need for additional services and interventions. 3. The PIHP must ensure that comprehensive HealthCheck exams for children through two years of age include blood lead toxicity testing. Universal testing of children in this age range is a federal Medicaid requirement.
Sample 1
HealthCheck. The section below describes the HealthCheck requirements and responsibilities for MY2016. For MY2017 and beyond, the DHS will explore replacing the current HealthCheck measures with Bright Futures measures. Operational details for this modification will be discussed in the MY2017 HMO P4P Guide. 1. HMO Responsibilities for MY2016 a. Provide Comprehensive HealthCheck services as a continuing care provider and according to policies and procedures in Wisconsin Health Care Programs Online Handbook related to covered services. b. Provide Comprehensive HealthCheck screens upon request. The HMO must provide a HealthCheck screen within 60 days (if a screen is due according to the periodicity schedule) for members over one year of age for which a parent or guardian of a member requests a Comprehensive HealthCheck screen. If the screen is not due within 30 days, then the HMO must schedule the appointment in accordance with the periodicity schedule. The HMO must provide a Comprehensive HealthCheck screen within 30 days (if a screen is due according to the periodicity schedule) for members up to one year of age for which a parent or guardian of a member requests a Comprehensive HealthCheck screen. If the screen is not due within 30 days, then the HMO must schedule the appointment in accordance with the periodicity schedule. c. Provide Comprehensive HealthCheck screens at a rate equal to or greater than 80% of the expected number of screens. Comprehensive HealthCheck screen for children through two years of age generally include both Blood Lead Toxicity testing and age appropriate immunizations. 2. Department Responsibilities a. MY2016 calculations for each HMO’s performance on the HealthCheck measure will be made using 2014-2015 methodology. However, instead of the 2014-2015 methodology for recoupment when performance falls below the 80% target, there will be a flat assessment of $10,000 for any HMO missing the 80% target. This penalty is not part of the other HMO P4P measures and withhold. Operational details for this modification, including opportunities for HMOs to provide additional information, will be discussed in the MY2016 HMO P4P Guide. For MY2017 and beyond, the DHS will explore replacing the current HealthCheck measure with Bright Futures measures. Operational details for this modification will be discussed in the MY2017 HMO P4P Guide.
Sample 1
HealthCheck. HealthCheck is Wisconsin’s name for the federally required Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit for Medicaid-enrolled children under age 21. The purpose of HealthCheck is to provide comprehensive preventative services to identify health problems early and to assure coordinated follow-up services. Title V/MCH and Title XIX/Medicaid programs have a mutual commitment to improving services to this population. In order to maximize the effective operation of Wisconsin’s fee-for-service Title XIX and Title V/MCH Programs, the following methods for coordination have been established: A. Promote HealthCheck preventive services, including immunizations and lead screening, within MCH/CYSHCN and WIC programs. B. Support Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents, which is listed as a resource for providers conducting HealthCheck comprehensive examinations. C. Cooperate when providing technical consultation for potential HealthCheck screeners. D. Provide reports of established services upon request.
Sample 1
HealthCheck. Provide services as a continuing care provider as defined in Article I, and according to policies and procedures in Part D of the Wisconsin Medicaid Provider Handbook related to covered services. Provide HealthCheck screens at a rate equal to or greater than 80 percent of the expected number of screens. The rate of HealthCheck screens will be determined by the calculation in the HealthCheck Worksheet in Addendum XI. The Department will complete the worksheet from data provided by the HMO- from the HMO Utilization Report for calendar year 2000 and, for calendar year 2001, from HealthCheck screens the Department retrieves and identifies from the 2001 encounter data set. The HMO may complete the worksheet on its own, periodically, as a means to monitor its HealthCheck screening performance. HMO Contract for January 1, 2000 - December 31, 2001 For the 2000 HealthCheck worksheet data calculation, the number of HealthCheck screens reported on the 2000 HMO utilization Report must be substantiated by the number reported on the 2000 encounter data set. If for the year 2000, the encounter data set does not substantiate the HealthCheck screens reported on the HMO Utilization Report within 5 percent, the Department will require HMOs to submit a 2001 HMO Utilization Report. When the Department completes the HealthCheck worksheet using encounter data for calendar year 2001, the Department will identify and retrieve HealthCheck screening data from the encounter data set as of July 1, 2002. For those HMOs required to submit a 2001 HMO Utilization Report, the Department will compare the HealthCheck data submitted on the 2001 HMO Utilization Report with HealthCheck data reported on the encounter data set, and utilize the smaller number when completing the worksheet. If the HMO provides fewer screens in the contract year than 80 percent, the Department will recoup the funds provided to the HMO for the provision of the remaining screens. This formula will be used:
Sample 1
HealthCheck. HealthCheck is Wisconsin’s name for the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for children under age 21. The EPSDT benefit is defined in federal law at §1905(r) of the Social Security Act. The benefit provides comprehensive and preventive health care services for all children under 21 years old. Federal and state regulations establish certain requirements for comprehensive HealthCheck screenings. A comprehensive HealthCheck screen includes all of the following components: a. A complete health and developmental history (including anticipatory guidance). b. A comprehensive unclothed physical examination. c. An age-appropriate vision screening exam. d. An age-appropriate hearing screening exam. e. An oral assessment plus referral to a dentist beginning at one year of age. f. The appropriate immunizations (according to age and health history). g. The appropriate laboratory tests (including blood lead level testing when appropriate for age).
Sample 1
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HealthCheck. HealthCheck is Wisconsin’s name for the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for children under age 21. The EPSDT benefit is defined in federal law at §1905(r) of the Social Security Act and provides comprehensive and preventive health care services for all children under 21 years old. Federal and state regulations establish certain requirements for comprehensive HealthCheck screenings.
Sample 1

Related to HealthCheck

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