Common use of Reassessments Clause in Contracts

Reassessments. The Contractor will develop a process for reviewing and updating the care plans with members on an as-needed basis, including upon reassessment of functional need, when the member’s circumstances or needs change significantly, or at the request of the member, but no less often than annually per 42 CFR 441.301(c)(3). It is expected that members in complex case management and RCP will have care plans reviewed and updated on a schedule more often than annually. In addition, members may move between stratified levels of care groups over time as their needs change, therefore, the Contractor shall develop a protocol for re-evaluating members periodically to determine if their present care levels are adequate. The Contractor shall also identify triggers which would immediately move the member to a more assistive level of service. The Contractor must at minimum re-screen and conduct a comprehensive health assessment for members who have been in the program for three (3) years. Additionally, any member or provider can request a level of care redetermination at any time.

Reassessments. The Contractor will develop a process for reviewing and updating the care plans with members on an as-needed basis, including upon reassessment of functional need, need when the member’s circumstances or needs change significantly, or at the request of the member, but no less often than annually per 42 CFR 441.301(c)(3). It is expected that members in complex case management and RCP will have care plans reviewed and updated on a schedule more often than annually. In addition, members may move between stratified levels of care groups over time as their needs change, therefore, the Contractor shall develop a protocol for re-re- evaluating members periodically to determine if their present care levels are adequate. The Contractor shall also identify triggers which would immediately move the member to a more assistive level of service. The Contractor must at minimum re-re- screen and conduct a comprehensive health assessment for members who have been in the program for three (3) years. Additionally, any member or provider can request a level of care redetermination at any time. The Contractor must also have a process for how members can request and, if available, be offered a different case manager according to the member’s preferences and language/cultural needs.

Reassessments. The Contractor will develop a process for reviewing and updating the care plans with members on an as-needed basis, including upon reassessment of functional need, when the member’s circumstances or needs change significantly, or at the request of the member, but no less often than annually per 42 CFR 441.301(c)(3). It is expected that members in complex case management and RCP will have care plans reviewed and updated on a schedule more often than annually. In addition, members may move between stratified levels of care groups over time as their needs change, therefore, the Contractor shall develop a protocol for re-re- evaluating members periodically to determine if their present care levels are adequate. The Contractor shall also identify triggers which would immediately move the member to a more assistive level of service. The Contractor must at minimum re-re- screen and conduct a comprehensive health assessment for members who have been in the program for three (3) years. Additionally, any member or provider can request a level of care redetermination at any time. The Contractor must also have a process for how members can request and, if available, be offered a different case manager according to the member’s preferences and language/cultural needs.

Reassessments. The Contractor will develop a process for reviewing and updating the care plans with members on an as-needed basis, including upon reassessment of functional need, need when the member’s circumstances or needs change significantly, or at the request of the member, but no less often than annually per 42 CFR 441.301(c)(3). It is expected that members in complex case management and RCP will have care plans reviewed and updated on a schedule more often than annually. In addition, members may move between stratified levels of care groups over time as their needs change, therefore, the Contractor shall develop a protocol for re-evaluating members periodically to determine if their present care levels are adequate. The Contractor shall also identify triggers which would immediately move the member to a more assistive level of service. The Contractor must at minimum re-screen and conduct a comprehensive health assessment for members who have been in the program for three (3) years. Additionally, any member or provider can request a level of care redetermination at any time.

Reassessments. The Contractor will develop a process for reviewing and updating the care plans with members on an as-needed basis, including upon reassessment of functional need, need when the member’s circumstances or needs change significantly, or at the request of the member, but no less often than annually per 42 CFR 441.301(c)(3). It is expected that members in complex case management and RCP will have care plans reviewed and updated on a schedule more often than annually. In addition, members may move between stratified levels of care groups over time as their needs change, therefore, the Contractor shall develop a protocol for re-re- evaluating members periodically to determine if their present care levels are adequate. The Contractor shall also identify triggers which would immediately move the member to a more assistive level of service. The Contractor must at minimum re-re- screen and conduct a comprehensive health assessment for members who have been in the program for three (3) years. Additionally, any member or provider can request a level of care redetermination at any time.