Common use of Care Team Clause in Contracts

Care Team. a multidisciplinary team responsible for coordinating certain aspects of a member’s care, as further described in Section 2.4.C. Chief Financial Officer – one of the Contractor’s Key Personnel roles, as described in Section 2.5.A. Chief Medical Officer/Medical Director – one of the Contractor’s Key Personnel roles, as described in Section 2.5.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. 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.G. Clinical Care Manager – as used in Appendix G 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’ 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. 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 Accountable Care Organization, 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 requirements of MassHealth as they relate to the treatment needs of that particular member. Community Partner (CP) Quality Score – a score calculated by EOHHS based on the CP’s performance on CP Quality Measures, as described in Appendix B. Comprehensive Assessment – a person-centered assessment of an Enrollee’s care needs, functional needs, accessibility needs, goals, and other characteristics, as described in Section 2.3.B.4 activities described in this Contract to Enrollees, which shall be April 1, 2023. Contractor (or “Primary Care Accountable Care Organization,” or “Primary Care ACO”) – any entity that enters into an agreement with EOHHS for the provision of services described in the Contract, as set forth in Appendix K.

Care Team. a multidisciplinary team responsible for coordinating certain aspects of a member’s care, as further described in Section 2.4.C. Chief Financial Officer – one of the Contractor’s Key Personnel roles, as described in Section 2.5.A. Chief Medical Officer/Medical Director – one of the Contractor’s Key Personnel roles, as described in Section 2.5.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. 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.G. Clinical Care Manager – as used in Appendix G 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’ 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. 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 Accountable ACO, Managed Care Organization, Organization (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 requirements of MassHealth as they relate to the treatment needs of that particular member. Community Partner (CP) Quality Score – a score calculated by EOHHS based on the CP’s performance on CP Quality Measures, as described in Appendix B. Comprehensive Assessment – a person-centered assessment of an Enrollee’s care needs, functional needs, accessibility needs, goals, and other characteristics, as described in Section 2.3.B.4 activities described in this Contract to Enrollees, which shall be April 1, 2023. Contractor (or “Primary Care Accountable Care Organization,” or “Primary Care ACO”) – any entity that enters into an agreement with EOHHS for the provision of services described in the Contract, as set forth in Appendix K.B.