Pennsylvania HealthChoices Physical Health Agreement

Authors: PA HealthChoices
Year: 2020
State: PA
Website link:
Publicly Available: Yes
Policy: MCO contract language and reimbursement models
Sustainable Financing: How to engage and work with Medicaid, MCO or bundled payment reimbursement models, Evidence-based interventions

Pennsylvania Medicaid MCO Agreement.

The Community Based Care Management (CBCM) Program requirements described in Exhibit B(5) are for care rendered during a CY and defined in the PH-MCO specific CBCM Program approved by the Department per Section I below. Proposals submitted for the CBCM program must increase the use of community-based staff, including certified Community Health Workers where appropriate, to encourage the use of preventive services, identify and resolve barriers to care, and mitigate social determinates of health. 

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