Supporting implementation and use of evidence-based practice guidelines; Developing Plans of Care and related coordination; and Determining outcomes (e.g., clinical, functional, recovery, satisfaction, and cost outcomes). Health Home Practice (HHP) The HHP must execute a MaineCare Provider Agreement. The HHP must have received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PPC-PCMH) Recognition within one (1) year from the date of enrollment and be located in the state of Maine. The HHP must be approved as an HHP by the Department through the HHP application process. The HHP must have a implemented EHR. The HHP must have an executed contract or memorandum of agreement with at least one BHHO in its area that describes procedures and protocols for regular and systematized communication and collaboration across the two agencies, the roles and responsibilities of each organization in service delivery, and other information necessary to effectively deliver, pay, and receive reimbursement for all BHH services to all shared members without duplication. This may include names and contact information of key staff at the BHHO and HHP, acceptable mode(s) of electronic communication to ensure effective and privacy-protected exchange of health information, frequency of communication at both leadership and practice levels (e.g., weekly, monthly, quarterly), procedures for bi-directional access to member Plan of Care and other health information, referral protocols for new members, collaboration on treatment plans and member goals and, as needed, Business Associate Agreement/Qualified Service Organization addenda. The HHP must have established member referral protocols with area hospitals and residential facilities. The protocols must include coordination and communication on enrolled or potentially eligible members. The HHP must have systematic follow-up protocols to assure timely access to follow-up care. The HHP must comply with Ch. VI, Section 1-Primary MaineCare Benefits Manual, Care Case Management, Section 1.08-5-Twenty-Four Hour Coverage. The HHP must participate in Health Home technical assistance opportunities, as determined by the Department, and as described in Section 91, Health Homes. C.M.R. Ch. 101, Ch. II, Sec. 91.03-1(9)(a)) 92.02 PROVIDER REQUIREMENTS (cont.)
Supporting implementation and use of evidence-based practice guidelines; Developing Plans of Care and related coordination; and Determining outcomes (e.g., clinical, functional, recovery, satisfaction, and cost outcomes). Health Home Practice (HHP) The HHP must execute a MaineCare Provider Agreement. The HHP must have received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PPC-PCMH) Recognition within one (1) year from the date of enrollment and be located in the state of Maine. The HHP must be approved as an HHP by the Department through the HHP application process. The HHP must have a implemented EHR. The HHP must have an executed contract or memorandum of agreement with at least one BHHO in its area that describes procedures and protocols for regular and systematized communication and collaboration across the two agencies, the roles and responsibilities of each organization in service delivery, and other information necessary to effectively deliver, pay, and receive reimbursement for all BHH services to all shared members without duplication. This may include names and contact information of key staff at the BHHO and HHP, acceptable mode(s) of electronic communication to ensure effective and privacy-protected exchange of health information, frequency of communication at both leadership and practice levels (e.g., weekly, monthly, quarterly), procedures for bi-directional access to member Plan of Care and other health information, referral protocols for new members, collaboration on treatment plans and member goals and, as needed, Business Associate Agreement/Qualified Service Organization addenda. The HHP must have established member referral protocols with area hospitals and residential facilities. The protocols must include coordination and communication on enrolled or potentially eligible members. The HHP must have systematic follow-up protocols to assure timely access to follow-up care. The HHP must comply with MaineCare Benefits Manual, Ch. VI, Section 1-Primary Care Case Management, Section 1.08-5-Twenty-Four Hour Coverage. The HHP must participate in Health Home technical assistance opportunities, as determined by the Department, and as described in Section 91, Health Homes. C.M.R. Ch. 101, Ch. II, Sec. 91.03-1(9)(a)) 92.02 PROVIDER REQUIREMENTS (cont.)