Common use of Timeframes for Comprehensive Assessment and Signed MCP Clause in Contracts

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx Obtain the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Services‌ Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A For Family Care and Partnership members, a comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. For PACE members, a comprehensive assessment shall be completed promptly following enrollment according to 42 C.F.R. § 460.104. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx Obtain the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A comprehensive assessment shall be completed within thirty (30) calendar days of the in a timely manner following enrollment dateas required by 42 C.F.R. § 460.104. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty thirty (6030) calendar days of the enrollment date. Documentation Document Timelines The MCO PO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO PO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- SSI-E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCOPO’s procedures for accessing long-term care services in the benefit packageservices; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCOPO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A For Family Care and Partnership members, a comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. For PACE members, a comprehensive assessment shall be completed promptly following enrollment according to 42 C.F.R. § 460.104. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including:

Timeframes for Comprehensive Assessment and Signed MCP. Comprehensive Assessment A comprehensive assessment shall be completed within thirty (30) calendar days of the enrollment date. Member-Centered Plan (MCP) A fully developed MCP shall be completed and signed by the member or the member’s legal decision maker within sixty (60) calendar days of the enrollment date. Documentation Timelines Timelines‌ The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Providing, Arranging, Coordinating and Monitoring Services Providing and Arranging for Services The IDT staff is formally designated as being primarily responsible for coordinating the member’s overall long-term care and health care. In accordance with the MCP, the IDT staff shall authorize, provide, arrange for or coordinate services in the benefit package in a timely manner. Coordination with Other Services The IDT staff shall ensure coordination of long-term care services with health care services received by the member, as well as other services available from natural and community supports. This includes but is not limited to assisting members to access social programs when they are unable to do so themselves and, if requested, providing information to a member about how to choose a Medicare Part D Prescription Drug Plan. This also includes assisting the member to obtain and maintain eligibility for SSI- E, if applicable (refer to the SSI-E Policy Handbook: xxxx://xxx.xxxxxxxxxxx.xxxxxxxxx.xxx/ssi-e/ssi-e.htm). Access to Services The IDT staff will arrange for, and instruct members on how to obtain, services. The IDT staff shall at a minimum: Within thirty (30) calendar days of enrollment, document the member’s primary care provider, specialty care provider(s), and psychiatrist (if applicable); Xxxxxx Obtain the member’s authorization, as required by law, to receive and share appropriate health care information; Provide information about the MCO’s procedures for accessing long-term care services in the benefit package; Provide the member with education on how to obtain needed primary and acute health care services; Educate members in the MCO’s expectations in the effective use of primary care, specialty care and emergency services; including: