Medical home pilot projects.

(a)#

The department may administer the medical home initiative as a service delivery mechanism to provide and coordinate care for individuals who are eligible for a Medical Assistance program under this subchapter that provides services under a fee-for-service model. The department may administer a medical home initiative to serve individuals who are members of any of the following populations: 1. Children who are in out-of-home care or are receiving adoption assistance under 42 USC 670 to 679c. 2. Pregnant women. 3. Individuals who are exiting mental health facilities or correctional facilities. 4. Individuals with a diagnosis of serious mental illness or substance abuse disorder. 5. Adults with two or more chronic medical conditions. 6. Other groups of individuals with conditions that the department determines would benefit from services through a medical home.

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Medical home pilot projects.

Official source

(a)#

The department may administer the medical home initiative as a service delivery mechanism to provide and coordinate care for individuals who are eligible for a Medical Assistance program under this subchapter that provides services under a fee-for-service model. The department may administer a medical home initiative to serve individuals who are members of any of the following populations: 1. Children who are in out-of-home care or are receiving adoption assistance under 42 USC 670 to 679c. 2. Pregnant women. 3. Individuals who are exiting mental health facilities or correctional facilities. 4. Individuals with a diagnosis of serious mental illness or substance abuse disorder. 5. Adults with two or more chronic medical conditions. 6. Other groups of individuals with conditions that the department determines would benefit from services through a medical home.

(a)(1)#

Children who are in out-of-home care or are receiving adoption assistance under 42 USC 670 to 679c.

(a)(2)#

Pregnant women.

(a)(3)#

Individuals who are exiting mental health facilities or correctional facilities.

(a)(4)#

Individuals with a diagnosis of serious mental illness or substance abuse disorder.

(a)(5)#

Adults with two or more chronic medical conditions.

(a)(6)#

Other groups of individuals with conditions that the department determines would benefit from services through a medical home.

(b)#

The department shall provide to individuals through any medical home initiative administered under this subsection the benefits described under s. 49.46 (2) (a) and (b). The department may provide to individuals though any medical home initiative administered under this subsection benefits in addition to the standard plan benefits that are targeted to the population receiving services through the medical home.

(c)#

The department may elect to administer any medical home initiative under this subsection in a limited geographical area.

(d)#

The department may make an all-inclusive payment to the provider offering services through a medical home.

(e)#

If the federal department of health and human services approves the department’s request to administer a medical home initiative, the department shall automatically enroll an individual who is eligible for a medical home initiative under this subsection in the medical home initiative. At any time after the first 6 months of enrollment in the medical home initiative, the individual who is enrolled in the medical home initiative may opt out of participation in the medical home initiative.