Care Plan the plan of care developed by the Enrollee and other individuals involved in the Enrollees care or Care Management, as described in Section 2.5.D.2, inclusive of Person-Centered Treatment Plans developed by BH CPs.
Care Plan the plan of care developed by the Enrollee and other individuals involved in the Enrollee’s care or Care Management, as described in Section 2.3.D.2. Care Team Point of Contact – A member of a BH CP-Engaged Enrollee’s care team responsible for ongoing communication with the care team. The Care Team Point of Contact may be the Enrollee’s PCP or PCP Designee, or the Contractor’s staff member that has face-to-face contact with the PCP or the care team. Chief Financial Officer – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Chief Medical Officer/Medical Director – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Child and Adolescent Needs and Strengths (CANS) Tool – a tool that provides a standardized way to organize information gathered during Behavioral Health Clinical Assessments and during the Discharge Planning process from Inpatient Mental Health Services and Community Based Acute Treatment Services as described in Appendix A. A Massachusetts version of the CANS Tool has been developed and is intended to be used as a treatment decision support tool for Behavioral Health Providers serving Enrollees under the age of 21. Children’s Behavioral Health Initiative (CBHI) -- an interagency undertaking by EOHHS and MassHealth whose mission is to strengthen, expand and integrate Behavioral Health Services for Members under the age of 21 into a comprehensive system of community-based, culturally competent care. Children’s Behavioral Health Initiative Services (CBHI Services) – any of the following services: Intensive Care Coordination (ICC), Family Support and Training, In-Home Behavioral Services (including Behavior Management Therapy and Behavior Management Monitoring) and Therapeutic Mentoring Services, In-Home Therapy Services (including Therapeutic Clinical Intervention and Ongoing Therapeutic Training and Support), and Mobile Crisis Intervention. Clinical Advice and Support Line – a phone line that provides Enrollees with information to support access to and coordination of appropriate care, as described in Section 2.3.C.3. Clinical Care Manager – a licensed Registered Nurse or other individual, employed by the Contractor or an Enrollee’s PCP and licensed to provide clinical care management, including intensive monitoring, follow-up, and care coordination, and clinical management of high-risk Enrollees, as further specified by EOHHS. Clinical Quality Measures – clinical information from Enrollees’ medic...
Care Plan. 39:01 The parties agree to the continuation of the Vision Care Plan with the following changes:
Care Plan the plan of care developed by the Enrollee and other individuals involved in the Enrollee’s care or Care Management, as described in Section 2.3.D.2. Chief Financial Officer – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Chief Medical Officer/Medical Director – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Children’s Behavioral Health Initiative (CBHI) -- an interagency undertaking by EOHHS and MassHealth whose mission is to strengthen, expand and integrate Behavioral Health Services for Members under the age of 21 into a comprehensive system of community-based, culturally competent care. Children’s Behavioral Health Initiative Services (CBHI Services) – any of the following services: Intensive Care Coordination (ICC), Family Support and Training, In-Home Behavioral Services (including Behavior Management Therapy and Behavior Management Monitoring) and Therapeutic Mentoring Services, In-Home Therapy Services (including Therapeutic Clinical Intervention and Ongoing Therapeutic Training and Support), and Mobile Crisis Intervention. Clinical Advice and Support Line – a phone line that provides Enrollees with information to support access to and coordination of appropriate care, as described in Section 2.3.C.3. Clinical Care Manager – a licensed Registered Nurse or other individual, employed by the Contractor or an Enrollee’s PCC and licensed to provide clinical care management, including intensive monitoring, follow-up, and care coordination, and clinical management of high-risk Enrollees, as further specified by EOHHS. Clinical Quality Measures – clinical information from Enrollees’ medical records used to determine the overall quality of care received by Enrollees or Members. Clinical Quality Measures are a subset of Quality Measures and are set forth in Appendix B. Cold-call Marketing – any unsolicited personal contact by the Contractor, its employees, Providers, agents or Material Subcontractors with a Member who is not enrolled in the Contractor’s plan that EOHHS can reasonably interpret as influencing the Member to enroll in the Contractor’s plan or either not to enroll in, or to disenroll from, another MassHealth-contracted Accountable Care Organization, MassHealth-contracted MCO, or the PCC Plan. Cold-call Marketing shall not include any personal contact between a Provider and a Member who is a prospective, current or former patient of that Provider regarding the provisions, terms or require...
Care Plan. An Enrollee-centered, goal-oriented, culturally relevant, and logical, written plan of care with a service plan component, if necessary, that assures that the Enrollee receives, to the extent applicable, medical, medically-related, social, behavioral, and necessary Covered Services, including long-term services and supports, in a supportive, effective, efficient, timely and cost-effective manner that emphasizes prevention and continuity of care. Center for Medicare and Medicaid Innovation (CMMI) - Established by Section 3021 of the Affordable Care Act, CMMI was established to test innovative payment and service delivery models to reduce program expenditures under Medicare and Medicaid while preserving or enhancing the quality of care furnished to individuals under such titles. CMS - Centers for Medicare & Medicaid Services. Comprehensive Third Party Insurance - As defined by the State’s HFS Bureau of Collections, major medical coverage that at least includes physician and hospital services. Consumer Assessment of Healthcare Providers and Systems (CAHPS) - Beneficiary survey tool developed and maintained by the Agency for Healthcare Research and Quality to support and promote the assessment of beneficiary experiences with health care. Contract Management Team - A group of CMS and HFS representatives responsible for overseeing the Three-way Contract. Covered Services - The set of Medicare and Medicaid services the Demonstration Plans are required to offer. Cultural Competence - Understanding those values, beliefs, and needs that are associated with age, gender identity, sexual orientation, and/or racial, ethnic, or religious backgrounds. Cultural Competence also includes a set of competencies, which are required to ensure appropriate, culturally sensitive health care to persons with congenital or acquired disabilities. Demonstration Plan - A managed care organization that enters into a Three-way Contract with CMS and the State to provide Covered Services and any chosen flexible benefits and be accountable for providing integrated care to Medicare-Medicaid Enrollees. Disenrollment – The process by which an Enrollee’s participation in the Demonstration is terminated. Reasons for disenrollment include death, loss of eligibility for the Demonstration, or choice not to participate in the Demonstration. Disenrollment at the direction of the Enrollee may also be referred to as “opt-out.”
Care Plan. (1) The participation agreement, these rules, and applicable provisions of law constitute the membership agreement between a public entity and the Missouri Consolidated Health Care Plan (MCHCP).
Care Plan. During the term of this Agreement and in consideration of the service fees referred in clause 6.1, Customer is entitled to receive, and Supplier shall have available the following Service for Equipment:
Care Plan. 8.1 The Council shall draw up a Care Plan for the child/young person within 5 working days of the child/young person’s admission. The care provided will be in accordance with the child’s Care Plan. The Care Plan will identify the purpose and objectives of the placement.
Care Plan. (1) If a participant is also covered under any other plan (as defined here) and is entitled to benefits or other services for which benefits are payable under this plan, the benefits under this plan will be adjusted as shown in this rule. XXXXX XXXXXXXX (5/31/10) Secretary of State CODE OF STATE REGULATIONS 17 22 CSR 10-3—MISSOURI CONSOLIDATED HEALTH CARE PLAN Division 10—Health Care Plan
Care Plan. The District shall provide all unit members, qualified retirees and their dependents with a vision care plan. The plan shall be Vision Service Plan B Composite Rate Non-deductible.
