Common use of Treatment Plan Development and Modification Clause in Contracts

Treatment Plan Development and Modification. (1) Treatment planning includes working with the enrollee, the enrollee’s natural support system, and all involved treating providers to develop an individualized plan for addressing identified clinical needs. A behavioral health care provider must complete a face-to-face interview with the enrollee during the development of the plan. WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract (2) In addition to the Handbook requirements, the individualized treatment plan shall: (a) Be recovery-oriented and promote resiliency; (b) Be enrollee-directed; (c) Accurately reflect the presenting problems of the enrollee; (d) Be based on the strengths of the enrollee, family, and other natural support systems; (e) Provide outcome-oriented objectives for the enrollee; (f) Include an outcome-oriented schedule of services that will be provided to meet the enrollee’s needs; (g) Include the coordination of services not covered by the Health Plan such as school-based services, vocational rehabilitation, housing supports, Medicaid fee-for-service substance abuse treatment, and physical health care; and (h) For enrollees in the child welfare system the individual treatment plans shall be coordinated with and complement the goals of the child welfare case plan. (3) Individualized treatment plan reviews shall be conducted at six (6) month intervals to assure that the services being provided are effective and remain appropriate for addressing individual enrollee needs. Additionally, a review is expected whenever clinically significant events occur or when treatment is not meeting the enrollee’s needs. The provider is expected to use the individualized treatment plan review process in the utilization management of medically necessary services. For further guidance see the most recent Community Behavioral Health Services and Coverage Handbook.

Treatment Plan Development and Modification. (1) Treatment planning includes working with the enrollee, the enrollee’s natural support system, and all involved treating providers to develop an individualized plan for addressing identified clinical needs. A behavioral health care provider must complete a face-to-face interview with the enrollee during the development of the plan. WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract. (2) In addition to the Handbook requirements, the individualized treatment plan shall: (a) Be recovery-oriented and promote resiliency; (b) Be enrollee-directed; (c) Accurately reflect the presenting problems of the enrollee; (d) Be based on the strengths of the enrollee, family, and other natural support systems;; HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract (e) Provide outcome-oriented objectives for the enrollee; (f) Include an outcome-oriented schedule of services that will be provided to meet the enrollee’s needs; (g) Include the coordination of services not covered by the Health Plan such as school-based services, vocational rehabilitation, housing supports, Medicaid fee-for-service substance abuse treatment, and physical health care; and (h) For enrollees in the child welfare system the individual treatment plans shall be coordinated with and complement the goals of the child welfare case plan. (3) Individualized treatment plan reviews shall be conducted at six (6) month intervals to assure that the services being provided are effective and remain appropriate for addressing individual enrollee needs. Additionally, a review is expected whenever clinically significant events occur or when treatment is not meeting the enrollee’s needs. The provider is expected to use the individualized treatment plan review process in the utilization management of medically necessary services. For further guidance see the most recent Community Behavioral Health Services and Coverage Handbook.

Treatment Plan Development and Modification. (1) Treatment planning includes working with the enrollee, the enrollee’s natural support system, and all involved treating providers to develop an individualized plan for addressing identified clinical needs. A behavioral health care provider must complete a face-to-face interview with the enrollee during the development of the plan. WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract. (2) In addition to the Handbook requirements, the individualized treatment plan shall: (a) Be recovery-oriented and promote resiliency; (b) Be enrollee-directed; (c) Accurately reflect the presenting problems of the enrollee; (d) Be based on the strengths of the enrollee, family, and other natural support systems; (e) Provide outcome-oriented objectives for the enrollee; (f) Include an outcome-oriented schedule of services that will be provided to meet the enrollee’s needs; (g) Include the coordination of services not covered by the Health Plan such as school-based services, vocational rehabilitation, housing supports, Medicaid fee-forfeefor-service substance abuse treatment, and physical health care; and (h) For enrollees in the child welfare system the individual treatment plans shall be coordinated with and complement the goals of the child welfare case plan.. AMERIGROUP Florida, Inc. d/b/a Medicaid Non-Reform and Reform AMERIGROUP Community Care HMO Contract (3) Individualized treatment plan reviews shall be conducted at six (6) month intervals to assure that the services being provided are effective and remain appropriate for addressing individual enrollee needs. Additionally, a review is expected whenever clinically significant events occur or when treatment is not meeting the enrollee’s needs. The provider is expected to use the individualized treatment plan review process in the utilization management of medically necessary services. For further guidance see the most recent Community Behavioral Health Services and Coverage Handbook.