MSHO Care Coordination Components. The Care Coordination system must be designed to ensure communication and coordination of an Enrollee's care across the Medicare and Medicaid network Provider types and settings, to ensure smooth transitions for Enrollees who move among various settings in which care may be provided over time, and to strive to facilitate and maximize the level of Enrollee self-determination and Enrollee choice of services, Providers and living arrangements. The Care Coordination system should provide each Enrollee with a primary contact person who will assist the Enrollee in simplifying access to services and information. The system must be designed to promote and assure service accessibility, attention to individual needs, continuity of care, comprehensive and coordinated service delivery, culturally appropriate care and fiscal and professional accountability. The system may differ for Institutional, Community NHC and community members but at a minimum, the Care Coordination system must incorporate the following elements for all MSHO Enrollees:
MSHO Care Coordination Components. The Care Coordination system must be designed to ensure communication and coordination of an Enrollee's care across the Medicare and Medicaid network Provider types and settings, to ensure smooth transitions for Enrollees who move among various settings in which care may be provided over time, and to strive to facilitate and maximize the level of Enrollee self-determination and Enrollee choice of services, Providers and living arrangements. The system must be designed to promote and assure service accessibility, attention to individual needs, continuity of care, comprehensive and coordinated service delivery, culturally appropriate care and fiscal and professional accountability. The Care Coordination system should provide each Enrollee with a primary contact person who will assist the Enrollee in simplifying access to services and information. This person must not be employed by a provider providing long term supports and services and who is listed on the individual care plan developed according to section 6.1.4.1(2) below, except when the MCO can demonstrate that the only willing and qualified entity to provide care coordination in a geographic area also provides long term supports and services. The MCO may request a transition period of up to one hundred and twenty (120) days in order to change care coordinators to meet this requirement. The system may differ for Institutional, Community NHC and community members but at a minimum, the Care Coordination system must incorporate the following elements for all MSHO Enrollees:
