Common use of Behavioral Health Care Coordination Clause in Contracts

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral health providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and emergency services. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor Respondents shall maintain submit a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a health profile to the member’s respective primary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The health profile provides, in a concise format, the physical and behavioral health treatment received by the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. As described in Section 8.1, effective July 1, 2015, the State intends to implement a new Medicaid Management Information System (MMIS). The State reserves the right to require the Contractor to utilize reporting capabilities through the new MMIS to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Any other relevant information. Contractors must, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor must develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor Respondents shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain propose mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon requestFSSA.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with EXHIBIT 1.E HOOSIER HEALTHWISE SCOPE OF WORK the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 1.E

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.five

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. The Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall share member medical develop strategies that will allow for the expansion of care coordination, data with physical reporting, and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when requiredoutcomes measurement. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA EXHIBIT 1.B. SCOPE OF WORK and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shallThe Contractor will have developed and implemented mechanisms to ensure coordination among member’s providers by the Contract Start Date. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives Emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and Emergency services. This notice must be provided within seventy-two (72) hours of the hospital inpatient admission or Emergency treatment. The Contractor shall maintain strategies to receive hospital notification of inpatient admissions to facilitate meeting this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a behavioral health profile to the member’s respective PMPprimary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The behavioral health profile lists provides, in a concise format, the physical and behavioral health treatment received by that the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. The State reserves the right to require the Contractor to utilize reporting capabilities through the Medicaid Management Information System (MMIS) to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  • Primary and secondary diagnoses;  • Findings from assessments;  • Medication prescribed;  • Psychotherapy prescribed; and  Other • Any other relevant information. Contractors shallmust, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop maintain additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical social, physical, and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. AdditionallyIncentive programs, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contactscase managers, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.profiles, etc. are potential

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.five

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s EXHIBIT 2.I SCOPE OF WORK – HEALTHY INDIANA PLAN inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 2.I

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral health providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and emergency services. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor Respondents shall maintain submit a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a health profile to the member’s respective primary medical and behavioral health provider. If the Contractor does not EXHIBIT 1.M SCOPE OF WORK utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The health profile provides, in a concise format, the physical and behavioral health treatment received by the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. As described in Section 8.1, effective July 1, 2015, the State intends to implement a new Medicaid Management Information System (MMIS). The State reserves the right to require the Contractor to utilize reporting capabilities through the new MMIS to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member: • Primary and secondary diagnoses; • Findings from assessments; • Medication prescribed; • Psychotherapy prescribed; and • Any other relevant information. Contractors must, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor must develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor Respondents shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain propose mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon requestFSSA.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. The Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall share member medical develop strategies that will allow for the expansion of care coordination, data with physical reporting, and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when requiredoutcomes measurement. The Contractor shall must contractually mandate that its behavioral health care network providers EXHIBIT 1.C SCOPE OF WORK notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral have developed and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement implemented mechanisms to ensure coordination among member’s providersproviders by the Contract Start Date. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency Emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and Emergency services. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.seventy -two

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its it s behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to Section 3.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision provis ion of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and EXHIBIT 1 SCOPE OF WORK behavioral health providers treating the member. The Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall share member medical develop strategies that will allow for the expansion of care coordination, data with physical reporting, and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when requiredoutcomes measurement. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shallThe Contractor will have developed and implemented mechanisms to ensure coordination among member’s providers by the Contract Start Date. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives Emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and Emergency services. This notice must be provided within seventy-two (72) hours of the hospital inpatient admission or Emergency treatment. The Contractor shall maintain strategies to receive hospital notification of inpatient admissions to facilitate meeting this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a behavioral health profile to the member’s respective PMPprimary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The behavioral health profile lists provides, in a concise format, the physical and behavioral health treatment received by that the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. The State reserves the right to require the Contractor to utilize reporting capabilities through the Medicaid Management Information System (MMIS) to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  • Primary and secondary diagnoses;  • Findings from assessments;  • Medication prescribed;  • Psychotherapy prescribed; and  Other • Any other relevant information. EXHIBIT 1 SCOPE OF WORK Contractors shallmust, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop maintain additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical social, physical, and behavioral health integration and information sharing. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination, and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPPFSSA. Documentation These new initiatives will result in a higher level of integration policies and procedures, contacts, behavioral health profile templates and outcomes data of services. The Contractor shall provide enhanced care coordination as may be made available to OMPP upon requestrequired as a result of these initiatives.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 1

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to Section 3.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral health providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and emergency services. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor Respondents shall maintain submit a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a health profile to the member’s respective primary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The health profile provides, in a concise format, the physical and behavioral health treatment received by the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. As described in Section 8.1, effective July 1, 2015, the State intends to implement a new Medicaid Management Information System (MMIS). The State reserves the right to require the Contractor to utilize reporting capabilities through the new MMIS to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member: • Primary and secondary diagnoses; • Findings from assessments; • Medication prescribed; • Psychotherapy prescribed; and • Any other relevant information. Contractors must, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor must develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor Respondents shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain propose mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon requestFSSA.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visitvis it, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.five

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s exte consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  Primary and secondary diagnoses;  Findings from assessments;  Medication prescribed;  Psychotherapy prescribed; and  Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s EXHIBIT 2.I SCOPE OF WORK – HEALHTY INDIANA PLAN inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 2.I

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to Section 3.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision provis ion of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPPFSSA. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP FSSA upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. The Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall share member medical develop strategies that will allow for the expansion of care coordination, data with physical reporting, and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when requiredoutcomes measurement. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shallThe Contractor will have developed and implemented mechanisms to ensure coordination among member’s providers by the Contract Start Date. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives Emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and Emergency services. This notice must be provided within seventy-two (72) hours of the hospital inpatient admission or Emergency treatment. The Contractor shall maintain strategies to receive hospital notification of inpatient admissions to facilitate meeting this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a behavioral health profile to the member’s respective PMPprimary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The behavioral health profile lists provides, in a concise format, the physical and behavioral health treatment received by that the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. The State reserves the right to require the Contractor to utilize reporting capabilities through the Medicaid Management Information System (MMIS) to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shallmust, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop maintain additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical social, physical, and behavioral health integration and information sharing. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination, and the reciprocal exchange of health information between physical and behavioral health providers . The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPPFSSA. Documentation These new initiatives will result in a higher level of integration policies and procedures, contacts, behavioral health profile templates and outcomes data of services. The Contractor shall provide enhanced care coordination as may be made available to OMPP upon requestrequired as a result of these initiatives.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 1

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:   Primary and secondary diagnoses;   Findings from assessments;   Medication prescribed;   Psychotherapy prescribed; and  Other  Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall must ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall must coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall must have policies and procedures in place to facilitate the reciprocal exchange of social, physical and behavioral health information between physical and behavioral health providers treating the member. The Given the State’s commitment to increasing the levels of Primary Care Behavioral Health Integration across its care infrastructure, the Contractor shall share member medical develop strategies that will allow for the expansion of care coordination, data with physical reporting, and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when requiredoutcomes measurement. The Contractor shall must contractually mandate that its behavioral health care network providers notify the a member’s Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) HIPAA and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall Contractors must contractually require every network provider, including behavioral health providers, provider to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP member’s physical or behavioral health providerproviders, if applicable. Contractors shallThe Contractor will have developed and implemented mechanisms to ensure coordination among member’s providers by the Contract Start Date. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives Emergency treatment for behavioral health issues, including substance abuse. Refer to Section 3.12 for notification requirements for non-behavioral health admissions and Emergency services. This notice must be provided within seventy-two (72) hours of the hospital inpatient admission or Emergency treatment. The Contractor shall maintain strategies to receive hospital notification of inpatient admissions to facilitate meeting this requirement, for example, through the use of incentive programs. The Contractor must, on at least a quarterly basis, send a behavioral health profile to the member’s respective PMPprimary medical and behavioral health provider. If the Contractor does not utilize a PMP model as described in Section 6.2.3, mechanisms must be in place to identify the appropriate physical and behavioral health provider responsible for the member’s care to whom the health profile will be sent. The behavioral health profile lists provides, in a concise format, the physical and behavioral health treatment received by that the member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. The Contractor shall provide a template of the proposed health profile to be utilized for FSSA review and approval. The State reserves the right to require the Contractor to utilize reporting capabilities through the Medicaid Management Information System (MMIS) to implement the health profile requirement. The State shall provide advanced notice to the Contractor if this option will be implemented. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shallmust, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop maintain additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical social, physical, and behavioral health integration and information sharing. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination, and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP FSSA upon request request, and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration activities at the direction of OMPPFSSA. Documentation These new initiatives will result in a higher level of integration policies and procedures, contacts, behavioral health profile templates and outcomes data of services. The Contractor shall provide enhanced care coordination as may be made available to OMPP upon requestrequired as a result of these initiatives.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s inpatient visit and within five (5) days of a member's initial referral visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  Other ▪ Any other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and EXHIBIT 2.H HEALTHY INDIANA PLAN SCOPE OF WORK implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Refer to section 6.13 for notification and continuity of care requirements for non-behavioral health admissions and emergency services. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-State- driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 2-6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:   Primary and secondary diagnoses;   Findings from assessments;   Medication prescribed;   Psychotherapy prescribed; and   Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.

Behavioral Health Care Coordination. The Contractor shall ensure the coordination of physical and behavioral health care among all providers treating the member. The Contractor shall coordinate services for individuals with multiple diagnoses of mental illness, substance abuse and physical illness. The Contractor shall have policies and procedures in place to facilitate the reciprocal exchange of health information between physical and behavioral providers treating the member. The Contractor shall share member medical data with physical and behavioral health providers and coordinate care for all members receiving both physical and behavioral health services, to the extent permitted by law and in accordance with EXHIBIT 1.E HOOSIER HEALTHWISE SCOPE OF WORK the member’s consent, when required. The Contractor shall contractually mandate that its behavioral health care network providers notify the Contractor within five (5) calendar days of the member’s visit, and submit information about the treatment plan, the member’s diagnosis, medications, and other pertinent information. Disclosure of mental health records by the provider to the Contractor and to the member’s physician is permissible under the Health Insurance Portability and Accountability Act (HIPAA) and state law (IC 16-39-2- 6(a)) without consent of the patient because it is for treatment. However, consent from the patient is necessary for substance abuse records. The Contractor shall contractually require every network provider, including behavioral health providers, to ask and encourage members to sign a consent that permits release of substance abuse treatment information to the Contractor and to the PMP or behavioral health provider, if applicable. Contractors shall, on at least a quarterly basis, send a behavioral health profile to the respective PMP. The behavioral health profile lists the physical and behavioral health treatment received by that member during the previous reporting period. Information about substance abuse treatment and HIV/AIDS should only be released if member consent has been obtained. For each member receiving behavioral health treatment, the Contractor will contractually require behavioral and physical health providers to document and reciprocally share the following information for that member:  ▪ Primary and secondary diagnoses;  ▪ Findings from assessments;  ▪ Medication prescribed;  ▪ Psychotherapy prescribed; and  ▪ Other relevant information. Contractors shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Contractor shall implement mechanisms to ensure coordination among member’s providers. With appropriate consent, the Contractor shall notify behavioral health providers and medical providers when a member is hospitalized or receives emergency treatment for behavioral health issues, including substance abuse. This notice must be provided within five (5) calendar days of the hospital inpatient admission or emergency treatment. The Contractor shall maintain a description of strategies proposed to receive hospital notification of inpatient admissions to facilitate meeting the requirement for example, through the use of incentive programs. The Contractor shall develop additional mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. Incentive programs, case managers, behavioral health profiles, etc. are potential mechanisms to ensure care coordination and the reciprocal exchange of health information between physical and behavioral health providers. The Contractor shall require the behavioral health provider to share clinical information directly with the member’s PMP. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. The Contractor must develop mechanisms for facilitating communication between behavioral health and physical health providers to ensure the provision of integrated member care. The Contractor shall maintain mechanisms for ensuring physical and behavioral health integration and information sharing. The Contractor shall evaluate and monitor the effectiveness of its policies and procedures regarding physical and behavioral health coordination and develop and implement mechanisms to improve coordination and continuity of care based on monitoring outcomes. Documentation of integration policies and procedures and outcomes data shall be made available to OMPP upon request and at minimum on a semi-annual basis. Additionally, the State is exploring implementation of new initiatives for behavioral and physical health integration for Indiana Medicaid members. The Contractor shall participate in the planning and execution of State-driven integration at the direction of OMPP. Documentation of integration policies and procedures, contacts, behavioral health profile templates and outcomes data shall be made available to OMPP upon request.EXHIBIT 1.E