Common use of Information Sharing for New Members Clause in Contracts

Information Sharing for New Members. a. Counties must have policies and procedures to utilize member- specific information provided by DHS to prevent duplication of activities and as input into any needs stratification or care plan development activities. This may include results of any screens completed by the member, claims/encounter history, FFS prior authorization data, high-risk pregnancy indicators, and upcoming non-emergency medical transportation trips. (Pursuant to 42 CFR § 438.208(b)(4)) b. Share with other HMOs (which may include Medicare or commercial plans, or members transitioning to a BadgerCare Plus or Medicaid SSI HMO) serving the member the results of its identification and assessment of any member with special health care needs (see Art. I for definition of special health care needs assessment) so that those activities need not be duplicated as described in 42 CFR § 438.208(b)(4).

Information Sharing for New Members. a. Counties must have policies and procedures to utilize member- specific information provided by DHS to prevent duplication of activities and as input into any needs stratification or care plan development activities. This may include results of any screens completed by the member, claims/encounter history, FFS prior authorization data, high-risk pregnancy indicators, and upcoming non-emergency medical transportation trips. (Pursuant to 42 CFR § 438.208(b)(4)) b. ) • Share with other HMOs (which may include Medicare or commercial plans, or members transitioning to a new BadgerCare Plus or Medicaid SSI HMO) serving the member the results of its identification and assessment of any member with special health care needs (see Art. I for definition of special health care needs assessment) so that those activities need not be duplicated as described in 42 CFR § 438.208(b)(4).

Information Sharing for New Members. a. Counties must have policies and procedures to utilize member- specific information provided by DHS to prevent duplication of activities and as input into any needs stratification or care plan development activities. This may include results of any screens completed by the member, claims/encounter history, FFS prior authorization data, high-risk pregnancy indicators, and upcoming non-emergency medical transportation trips. (Pursuant to 42 CFR § 438.208(b)(4)) b. Share with other HMOs (which may include Medicare or commercial plans, or members transitioning to a new BadgerCare Plus or Medicaid SSI HMO) serving the member the results of its identification and assessment of any member with special health care needs (see Art. I for definition of special health care needs assessment) so that those activities need not be duplicated as described in 42 CFR § 438.208(b)(4).

Information Sharing for New Members. a.  Counties must have policies and procedures to utilize member- specific information provided by DHS to prevent duplication of activities and as input into any needs stratification or care plan development activities. This may include results of any screens completed by the member, claims/encounter history, FFS prior authorization data, high-risk pregnancy indicators, and upcoming non-emergency medical transportation trips. (Pursuant to 42 CFR § 438.208(b)(4)) b. )  Share with other HMOs (which may include Medicare or commercial plans, or members transitioning to a new BadgerCare Plus or Medicaid SSI HMO) serving the member the results of its identification and assessment of any member with special health care needs (see Art. I for definition of special health care needs assessment) so that those activities need not be duplicated as described in 42 CFR § 438.208(b)(4).

Information Sharing for New Members. a. Counties must have policies and procedures to utilize member- specific information provided by DHS to prevent duplication of activities and as input into any needs stratification or care plan development activities. This may include results of any screens completed by the member, claims/encounter history, FFS prior authorization data, high-risk pregnancy indicators, and upcoming non-emergency medical transportation trips. (Pursuant to 42 CFR § 438.208(b)(4)) b. ) • Share with other HMOs (which may include Medicare or commercial plans, or members transitioning to a new BadgerCare Plus or Medicaid SSI HMO) serving the member the results of its identification and assessment of any member with special health care needs (see Art. I for definition of special health care needs assessment) so that those activities need not be duplicated as described in 42 CFR § 438.208(b)(4).