Common use of Case Management Clause in Contracts

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a LPHA or a certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor shall only allow DMC providers to ▇▇▇▇ for physician consultation services.

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a LPHA or a certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services. 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor shall only allow DMC providers to ▇▇▇▇ for physician consultation services.

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a an LPHA or a registered or certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services. 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor shall only allow DMC providers to ▇▇▇▇ for physician consultation services.

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a an LPHA or a registered or certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor shall only allow DMC providers to ▇▇▇▇ for physician consultation services.

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a an LPHA or a registered or certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor Contractor’s subcontractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor or subcontractor shall only allow DMC providers to ▇▇▇▇ bill for physician consultation services.

Case Management. 1. Case management services are defined as a service that assist a beneficiary to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. 2. The Contractor shall ensure that case management services focus on coordination of SUD care, integration around primary care especially for beneficiaries with a chronic substance use disorder, and interaction with the criminal justice system, if needed. 3. The Contractor shall be responsible for determining which entity monitors the case management activities. 4. Case management services may be provided by a an LPHA or a registered or certified counselor. 5. The Contractor shall coordinate a system of case management services with physical and/or mental health in order to ensure appropriate level of care. 6. Case management services may be provided face-to-face, by telephone, or by telehealth with the beneficiary and may be provided anywhere in the community. S. Physician Consultation Services 1. Physician Consultation Services include DMC physicians’ consulting with addiction medicine physicians, addiction psychiatrists or clinical pharmacists. Physician consultation services are designed to assist DMC physicians by allowing them to seek expert advice when developing treatment plans for specific DMC-ODS beneficiaries. Physician consultation services may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. 2. Contractor Contractor’s subcontractor may contract with one or more physicians or pharmacists in order to provide consultation services. 3. The Contractor or subcontractor shall only allow DMC providers to ▇▇▇▇ for physician consultation services.