Role of primary care providers


AZ | AZBH | CA | CO | CT | DE | HI | HIBH | IL | IN | IA | IABH | KY | ME | MD | MA | MI | MO | MT | NE


NEBH | NV | NJ | NM | NY | ND | OH | OK | ORMH | PA | PABH | RI | SC | TN | TX | UT | UTMH | VA | WA | WV



AZ

"SECTION D: PROGRAM REQUIRMENTS
1.  SCOPE OF SERVICES...
Covered services must be medically necessary and provided by, or coordinated with, a primary care provider, except for behavioral health and children's preventive dental services…"  Arizona Contract, page 10.

"2.  BEHAVIORAL HEALTH SERVICES...
Coordination of Care: The Contractor is responsible for ensuring that a medical record is established by the PCP when behavioral health information is received from the RBHA or provider about an assigned member even if the PCP has not yet seen the assigned member...
Medication Management Services: ...

The Contractor shall ensure that training and education is available to PCPs regarding behavioral health referral and consultation procedures...Also, Contractors shall inform PCPs about the availability of training and education through the Regional Behavioral Health Authorities regarding the diagnosis and treatment of behavioral health disorders."  Arizona Contract, pages 16-17.

"22.  PRIMARY CARE PROVIDER STANDARDS...
At a minimum, the Contractor shall hold the PCP responsible for the following gatekeeping activities:
  a. Supervision, coordination and provision of care to each assigned member
  b. Initiation of referrals for medically necessary specialty care
  c. Maintaining continuity of care for each assigned member
  d. Maintaining the member’s medical record, including documentation of all services provided to the member by the PCP, as well as any specialty or referral services.

The Contractor shall establish and implement policies and procedures to monitor PCP gatekeeping activities and to ensure that PCPs are adequately notified of, and receive documentation regarding, specialty and referral services provided to assigned members by specialty physicians, dentists and other health care professionals...PCPs and specialists who provide inpatient services to the Contractor’s members shall have admitting and treatment privileges in a minimum of one general acute care hospital that is located within the Contractor’s service area."  Arizona Contract, page 32.

"44.  MEDICAL RECORDS...
When a member changes PCPs, his or her medical records or copies of medical records must be forwarded to the new PCP within 10 working days from receipt of the request for transfer of the medical records."  Arizona Contract, page 45.

AZBH

"ADHS shall ensure that the subcontracted RBHAs/providers send written notification, and the results of the evaluation and information regarding the planned course of treatment to the member's PCP, whether or not the PCP was the referral source."  Arizona Behavioral Health Contract, page 15.

"8.  ASSIGNED CLINICIAN
Maricopa County GSA:  ADHS shall ensure that each Title XIX or Title XXI member in the Maricopa County GSA identified by evaluation as needing covered behavioral health services is assigned to a clinician who is either a psychiatrist, certified psychiatric nurse practitioner, registered nurse, psychologist, physician assistant as defined in this contract, certified social worker, certified professional  counselor, certified marriage and family therapist or certified substance abuse counselor...

The Title XIX and Title XXI member is assigned to an assigned clinician who directly performs or is responsible for clinical supervision of the following activities:

a.  Ongoing assessment of existing and emerging behavioral health needs.
b.  Development, implementation and revision, as needed, of a service plan for active treatment and/or rehabilitation with revision of service delivery based on progress towards behavioral health goals.
c.  Maintenance of a complete and comprehensive behavioral health record of all covered services provided to the member, in accordance with AHCCCS and ADHS/DBHS policy.
d.  Provision of, or referral to, needed treatment, rehabilitative, supportive and ancillary covered services, including case management and referral to community resources.
e.  Monitoring of behavioral health condition, and provision of intervention as needed.
f.  Ongoing collaboration with parents, guardians, family members, primary care physicians, school, child welfare, juvenile or adult probation and/or parole, Developmental Disability provider, community and state agencies and other involved service providers.
g.  Maintenance of continuity of care between inpatient and outpatient settings.
h.  Facilitation and coordination of transfers out of area, out of state, or to an AHCCCS long term care contractor, as applicable.
i.  Development and implementation of transition, discharge, and aftercare plans prior to discontinuation of behavioral health services.
j.  By January 1, 2000, ADHS shall develop and submit a plan for implementation of the assigned clinician model for all other GSAs."  Arizona Behavioral Health Contract, pages 15-16.

"9.  CASE MANAGEMENT SERVICES...
In Maricopa county, case management services shall be provided by, or under the clinical supervision of, the primary behavioral health professional to whom the member is assigned as described in Paragraph 8 of this contract."  Arizona Behavioral Health Contract, page 16.

"14.  COORDINATION WITH AHCCCS ACUTE CARE CONTRACTORS...
ADHS shall ensure that the behavioral health records, copies, or summaries of relevant information of each Title XIX and Title XXI member are forwarded to the member's PCP at initiation of treatment, periodically during on-going treatment, regarding sentinel events and at discharge from services to provide information needed to accomplish medical management… At a minimum, the PCP should be notified in the following circumstances:
a.  Initiation and significant changes in psychotropic medications and significant adverse reactions
b.  Results of laboratory, radiology and other tests
c.  Emergency crisis admissions or events
d.  Events requiring medical consultation with PCP
e.  Discharge from an inpatient setting
f.  Disenrollment from ADHS/RBHA
g.  Initial Behavioral health evaluations, including outcome of screening

ADHS and its subcontracted RBHAs must adhere to confidentiality guidelines pursuant to 42 CFR 431.  Unless prescribed otherwise in statute, it is not necessary for ADHS subcontracted RBHAs to obtain a signed release form in order to share information with the PCP...

ADHS will ensure that information is available to health plan PCPs regarding subcontracted RBHA referral and consultation procedures.  Upon request, ADHS will provide education and training to health plan PCPs regarding diagnosis and treatment of behavioral health disorders."  Arizona Behavioral Health Contract, pages 18-19.

CA

"ARTICLE II - DEFINITIONS...
V1. Primary Care Physician  means a Physician responsible for supervising, coordinating, and providing initial and Primary Care to patients; for initiating referrals for specialist care; and for maintaining the continuity of patient care...

W1. Primary Care Provider means a person responsible for supervising, coordinating, and providing initial and Primary Care to Members; for initiating referrals and for maintaining the continuity of Member care."   California Contract, pages 2, 11-12.

"6.9.10 Primary Care Physician Assignment...
In all cases where a nurse practitioner or certified nurse midwife is a Member's Primary Care Provider, Contractor shall assure that an individual Primary Care Physician is responsible for the overall coordination of the Member's health care, consistent with applicable State and federal laws and regulations…"   California Contract, pages 138-139.

CO

"I.  DEFINITIONS
The following terms as used in this Contract shall be construed and interpreted as follows unless the context otherwise expressly requires a different construction and interpretation: ...

BG.  'Primary Care Physician' or 'Participating Primary Care Physician' shall mean the Physician who has entered into a professional service agreement to serve the Contractor's Members and has been designated by the Member, or the Member’s legal guardian as the Physician who will attend to the Member's routine medical care, supervise and/or coordinate all of the Member's health care, to and initiate all referrals."  Colorado Contract, page 10.

"XIV.  SERVICE DELIVERY…
D. Preventive Health Services
1. The Contractor shall establish and maintain a comprehensive program of preventive health services for Members that is used to minimize the risk of preventable illness and Secondary Disability and promote the highest level of wellness and appropriate self-care among Members.

2. The program of preventive health services shall include, but is not limited to:
  a.  risk assessment by a Member’s Primary Care Provider or other qualified professionals specializing in risk prevention who are part of the Contractor’s provider network or under contract to provide such services, to identify Members with chronic/high risk illnesses, Disabilities, or the potential for such conditions…"  Colorado Contract, pages 46, 51.

"XVIII. MEMBER RIGHTS AND RESPONSIBILITIES
A. Member Rights
The Contractor shall establish and maintain written policies and  procedures for treating all Members in a manner that is  consistent with all rights enumerated in 10 CCR 2050-10, §  8.207.5, as well as the following:
7.  to receive from the Member's Primary Care Physician, in terms that the Member understands, an explanation of his or her complete medical condition, recommended treatment, risk(s) of the treatment, expected results and reasonable medical alternatives…"  Colorado Contract, page 58.

"EXHIBIT A
COVERED SERVICES...
DEFINITION:  A covered services shall be deemed medically necessary if, in a manner consistent with accepted standards of medical practice ...

The medical necessity of a covered service shall be determined by the Contractor and the Member's PCP, in consultation with the Member or Member's guardian..."  Colorado Contract, Exhibit A, page 1.

CT

"Part II:  General Contract Terms for MCOs
1.  Definitions...
JJ.  Primary Care Provider (PCP):  A specific clinician responsible for coordinating the health care needs of certain Members…"  Connecticut Contract, pages 11-14.

DE

"8.1  PCP Responsibilities
The primary care provider serves as the member's initial and most important contact. As such, primary care provider responsibility must at a minimum include:

(a)  Maintaining continuity of each member's health care by serving as the member's primary care provider

(b)  Providing twenty-four (24) hour, seven (7) day a week access

(c)  Making referrals for specialty care and other medically necessary services, both in-plan and out-of-plan

(d)  Maintaining a current medical record for the member, including documentation of all services provided to the member by the PCP, as well as any specialty or referral services. Ensure that reports from all referral services are included in the PCP medical record.

(e)  Adhering to the EPSDT periodicity schedule for members under age twenty-one (21)

(f)  Following MCO established procedures for coordination of in-network and out-of-network services for members

Although PCPs must be given responsibility for the above activities, the MCO also must agree to retain responsibility for monitoring PCP actions to ensure they comply with MCO and Delaware Medicaid managed care program policies."  Delaware RFP, page II.53.

HI

"30.100  Offerors' Role in Managed Care...
The plan shall also provide each recipient with a primary care provider who assesses the recipient's health care needs and provides/directs the services to meet these needs." Hawaii RFP, page 8.

"30.420  Primary Care Provider (PCP)...
 The function of the PCP shall be to assess a recipient's health care needs and to provide services to meet these needs either directly or through the plan's provider network... A health plan which intends to utilize specialists and/or nurses as PCP's shall submit a plan for monitoring their performance as a PCP to DHS for approval prior to implementation..."  Hawaii RFP, pages 9-10.

"Primary care provider or PCP - is licensed in Hawaii and is 1) a physician, either an M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathy), and must generally be a family practitioner, general practitioner, general internist, pediatrician or obstetrician/gynecologist (for women, especially pregnant women); or 2) a nurse practitioner, and must generally be a family nurse practitioner, pediatric nurse practitioner or nurse midwife.  Has the responsibility for supervising, coordinating and providing initial and primary care to the enrollee and for initiating referrals and maintaining the continuity of enrollee care."  Hawaii RFP, Appendix A, page 5.

HIBH

"30.100 Offerors Role in Managed Care...
Since BHMC plan members will retain their primary care provider (PCP) (through the QUEST health plan) for coordination of QUEST medical services, the BHMC plan shall ensure the PCP is regularly updated on the member's diagnosis, treatment plans and ongoing care and that close coordination with the member's medical care is maintained."  Hawaii Behavioral Health RFP, page 14.

IL

"(o)  Choice of Physicians
The Contractor shall afford to each Beneficiary a physician who will supervise and coordinate his/her care, and to the extent feasible, within appropriate limits established by the Contractor and approved by the Department, shall afford the Beneficiary a choice of a physician..."  Illinois HMO Contract, page 45.

IN

"3.2.2  Primary Medical Providers
Hoosier Healthwise allows eligible Medicaid recipients to select a PMP who provides, through an ongoing recipient/PMP relationship, preventive and primary medical care, as well as authorization and referral for all medically necessary specialty services.  The PMP is available 24-hours a day, seven days a week, and assumes total management of the Medicaid recipient's non-emergency medical needs."  Indiana RFP, page 3-7.

"3.2  Describe the utilization controls under the child health assistance provided under the plan for targeted low-income children:  (Section 2102)(a)(4)

Hoosier HealthWise has a number of utilization control mechanisms in place that are designed to ensure that health care use is appropriate and medically necessary.  These mechanisms will be utilized under Phase II of the CHIP Program...

The managed care system established under Hoosier HealthWise also has some built in utilization controls.  The PMP serves as a gatekeeper who provides or authorizes primary care services and makes referrals for specialty care (except those which may be self-referred) when appropriate.  Referrals must be documented in the patient's medical record."  Indiana SCHIP Amendment, Attachment C-3, page 14.

IA

"1.3  Definitions...
- Primary Care Physician (PCP) - a physician under contract with the HMO who is duly licensed and certified under the laws of the state of Iowa.  A Primary Care Physician shall be responsible for the initial and primary care given to an Enrollee and shall be a general practitioner, internist, family practitioner, pediatrician or any other physician approved by the HMO.  If an Enrollee suffers from a chronic condition lasting, or anticipated to last, more than 12 months, and both the Provider and the Enrollee agree to provide and receive, respectively, a full spectrum of primary care services, other specialty Providers may be enrolled/assigned as a PCP."  Iowa Contract, pages 6, 9.

IABH

"E.  Oversight of the Utilization of Psychotropic Medications (proposal Section 7A.2.14)...
MBC of Iowa, with input from the Iowa Drug Utilization Review Commission, providers and PCPs, will include in the provider manual requirements to screen for any known drug allergies, other medications they are currently taking, changes in medications, adverse reactions to medications, changes to medical status and whether the client is pregnant.  This screening will be required at the onset of treatment and regularly throughout treatment...

MBC of Iowa will distribute an Iowa Plan manual, provider releases and educational materials to MBC of Iowa network providers as well as PCPs regarding coordination and communication of medication management, standards for preventing drug interactions and screening for drug allergies and pregnancy."  Iowa Behavioral Health Contract, pages 59-60.

KY

"7.6.3  Primary Care Provider Responsibilities
  The definition of a primary care provider (PCP) is a licensed or certified health care practitioner, including a …that functions within the scope of licensure or certification, has admitting privileges at a hospital or a formal referral agreement with a provider processing admitting privileges, and agrees to provide 24 hours per day, seven days a week primary health care services to individuals.  Primary care physician residents may function as PCPs.  The PCP shall serve as the member's initial and most important point of contact with The Partnership.  This role requires a responsibility to both The Partnership and the Member...

  Specialty providers may serve as PCPs under certain circumstances, depending on the member's needs...

PCP responsibilities shall include at a minimum:
  (a)  Maintaining continuity of each member's health care;
  (b)  Making referrals for specialty care and other medically-necessary services, both in and out of plan;
  (c)  Maintaining a current medical record for the Member, including documentation of all PCP and specialty care services;
  (d)  Discussing advance medical directives with all Members as appropriate;
  (e)  Providing 24-hour-per-day, seven-days-a week access to services and access to medically-necessary emergency services;
  (f)   Providing or arranging for all necessary preventive health care, including EPSDT for persons under the age of 21 years; and
  (g)  Maintaining formalized relationships with other PCPs to see their members for after hours care, during certain days, for certain services, or other reasons to extend their practice.  The PCP remains solely responsible for the PCP functions (a) through (f) above."  Kentucky RFA, pages 43-44.

ME

"II.  DEFINITIONS.
A.  The following terms used in this Contract shall be interpreted as defined herein, except to the extent that the context may clearly require otherwise: ...
45.  Primary Care Provider (‘PCP’) is the individual practitioner or team selected to provide and coordinate all of the Enrollee's health care needs and to initiate and monitor referrals for specialized services when required."  Maine Contract, pages 2, 7.

"3.4  SERVICE DELIVERY...
B.  PRIMARY CARE PROVIDERS...
1.  PCP Teams. The Contractor is encouraged to establish primary care provider teams that include certified nurse midwives, certified nurse practitioners, or physician assistants who, at the Enrollee's discretion, may serve as the point of first contact for the Enrollee. If the Contractor's primary care network includes institutions with teaching programs, primary care provider teams, comprised of residents and a supervising faculty physician, may serve as a PCP. The Contractor shall organize its PCP teams so as to ensure continuity of care to members, and shall identify a lead physician within the team for each member. The lead physician must be an attending physician and not a resident."  Maine Contract, pages 25-26.

MD

"10.09.64.10...
.10  Special Needs Populations.
An MCO applicant shall include in its application the following information and descriptions: ...
D.  Referral protocols that demonstrate the conditions under which PCPs will make the arrangements for children with special health care needs to be referred to specialty care networks."  Maryland COMAR 10.09.64.10.

MA

"SECTION 1.  DEFINITION OF TERMS...
Primary Care Practitioner (PCP) - the individual Primary Care Practitioner or team selected by the Enrollee, or as assigned to the Enrollee by the Contractor, to provide and coordinate all of the Enrollee's health care needs and to initiate and monitor referrals for specialty services when required…"  Massachusetts Contract, pages 6-14.

MI

"DEFINITIONS/EXPLANATION OF TERMS...
PCP
Primary Care Provider.  Those providers within the Health Plans who are designated as responsible for providing or arranging health care for specified Enrollees of the Contractor…"  Michigan Contract, pages vi, viii.

"II-M CONTRACTOR ORGANIZATIONAL STRUCTURE, ADMINISTRATIVE SERVICES, FINANCIAL REQUIREMENTS AND PROVIDER NETWORKS...
6. Provider Network in the CHCP...
(i) PCP Standards...
The PCP is responsible for supervising, coordinating and providing all primary care to each assigned Enrollee.  In addition, the PCP is responsible for initiating referrals for specialty care, maintaining continuity of each Enrollee's health care, and maintaining the Enrollee's medical record which includes documentation of all services provided by the PCP as well as any specialty or referral services…"  Michigan Contract, pages 32, 35, 39.

MO

"a.  Primary Care Provider Responsibilities:  The health plan must have written policies and procedures for limiting every member to a primary care provider.  The primary care provider must serve as the member's initial and most important contact.  As such, primary care provider responsibilities must include at a minimum:

1)  Maintaining continuity of each member's health care.
2)  Making referrals for specialty care and other medically necessary services, both in plan and out of plan.
3)  Maintaining a comprehensive current medical record for the member, including documentation of all services provided to the member by the primary care provider, as well as any specialty or referral services, diagnostic reports, physical and behavioral health screens, etc.
4)  Although primary care providers must be given responsibility for the above activities, the health plan also must agree to retain responsibility for monitoring primary care provider actions to ensure they comply with health plan and MC+ program policies.
5)  Primary care providers may have formalized relationships with other primary care providers to see their patients for after hours care, during certain days, for certain services, or other reasons to extend their practice.  However, the primary care provider retains sole responsibility for those functions in Performance Requirements segment, Item 2.2, paragraphs 2.2.2 a 1 through 2.2.2 a 4…"  Missouri RFP, page 24.

MT

"PRIMARY CARE PROVIDER (PCP)…The duties of the PRIMARY CARE PROVIDER shall be attending to the ENROLLEE's routine medical care, to supervise and coordinate all of the ENROLLEE's health care, to determine the need for and initiate all referrals, and to determine who shall perform medical services and whether the medical service is to be performed."  Montana Contract, page 29.

NE

"11.6 Public Health Nursing (PHN): A major component of the NHC is Public Health Nursing (PHN)...
11.6.1 Referrals to the PHN: Referrals to the PHN may be initiated by the PCP/plan, Department, or other appropriate individuals.
11.6.2 PHN as a Resource to the PCP/Plan: The EBS is a resource to the PCP/plan and the client...
11.6.3 PHN Coordination with PCP: The PHN component works as an extension of the PCP to improve the health and wellness of the client, but only after the PCP/plan has exercised his/her responsibilities.

11.7 Reasons for Referral: The EBS shall be responsible for promoting effective utilization of health resources to enable clients to better manage their own health care... Intervention by the EBS may occur in, but is not limited to, the following situations:...
(b) Serving as a resource to the PCP/plan in identifying other state and community-based agencies that provide vital health and social supports for clients;
(c) Assisting the PCP/plan in complying with federal requirements for HEALTH CHECK (EPSDT) services; and
(d) Assisting the PCP/plan in providing services to high-risk pregnant women and their infants, taking into account age, education, alcohol or drug use/abuse, weight, medical and psychosocial conditions and the need to ensure access to needed medical, social, educational and other services...

11.10 Documentation of Requests for PHN Services: The EBS shall document each request for PHN...
11.10.1 PCP Follow-up: The EBS shall contact the PCP within five working days of the request.
11.10.2 Development of a Care Plan: The PHN, in partnership with the client, PCP/plan, or other pertinent entities, shall develop a plan to address the needs identified in the assessment process to promote optimum levels of health and ensure the client is able to receive maximum benefits from medical intervention.

11.11 Coordination with the PCP/Plan and Healthcare Delivery Team: The PHN shall, in partnership with the client, coordinate with the PCP/plan information obtained regarding health status, lifestyle, and other information relevant to case management of the individual client.
11.11.1 PCP/Plan Consultation: The PHN shall present written reports and documentation to the PCP/plan, as appropriate, and consult in person or by telephone with the PCP/plan regarding the client according to established EBS protocols.

11.12 HEALTH CHECK (EPSDT) Outreach:...The EBS shall work cooperatively with the PCP/plan to:
(a) Promote preventive health care and encourage eligible children to receive HEALTH CHECK (EPSDT) screening examinations according to the American Academy of Pediatrics periodicity schedule.
(b) Receive referrals from the PCP/plan regarding children who missed screening appointments without cancellation based on guidelines established by the Department; contact with families to determine barriers to care, to assist in rescheduling appointments, and to counsel families about keeping appointments;
(c) Receive referrals from the PCP/plan regarding children who are screened, referred for further diagnosis and/or treatment and who did not follow-up with treatment services per guidelines set forth by the Department; contact families to determine barriers to care and to assist the families in initiating care in a manner that is supportive to the family…"  Nebraska Contract, pages 64-66.

"13.3.1 Functionality of the PCP: The client chooses or is assigned to a Primary Care Physician (PCP). The PCP is the physician who provides a "medical home” for the client and is responsible for referrals for all medically necessary services. PCPs may participate in one or all of the HMOs, and/or in the Primary Care Case Management (PCCM) Network, which is addressed under a separate contract..."  Nebraska Contract, page 78.

"13.7 PCP Qualifications and Responsibilities: Under the contractual responsibilities of the plan, the plan shall ensure that the PCP: ...
(2) Provide the Basic Benefits Package per 471 NAC to all clients who choose or are assigned to the PCP’s practice...
(3) Coordinate appropriate referrals when medically necessary to services that typically extend beyond those services provided directly by the PCP...
(4) As appropriate, work cooperatively with specialists, consultative services and other facilitated care situations for special needs clients...
(5) Provide continuous access to PCP services and necessary referrals of urgent or emergent nature available 24-hour, 7 days per week...
(6) Not refuse an assignment or disenroll a client or otherwise discriminate against a client...
(7) Ensure that ADA requirements and other appropriate technologies are utilized in the daily operations of the physician’s office...
(10) Maintain a medical record for each client and comply with the requirement to coordinate the transfer of medical record information if the client changes to another PCP;
(11) Utilize the Enrollment Broker Services and Public Health Nursing components of the NHC pursuant to this contract, as appropriate;
(12) Maintain a communication network that provides necessary information to any MH/SA services provider as frequently as necessary based on the client’s needs...
The PCP shall coordinate the provision, authorization, payment and the continuity of care, and the plan shall monitor overall coordination between these two service areas, i.e., medical/surgical and MH/SA….

(13) Communicate with agencies such as, but not limited to, local public health agencies for the purpose of participating in immunization registries and programs...
(14) Comply with all disease notification laws in the State;
(15) Provide information to the Department as required…"  Nebraska Contract, pages 80-81.

NEBH

"4.1  Applicable Definitions: The following definitions apply under this contract: ...
4.1.35  The term ‘Primary Care Physician (PCP)’, for purposes of the Basic Benefits Package, means a medical/surgical plan-credentialled physician chosen by the client or assigned by the Department who provides a ‘medical home’ for the client and whose primary expertise is in family practice, pediatrics, general practice, internal medicine, or obstetrics/gynecology…"  Nebraska Behavioral Health Contract, pages 6, 11.

NV

"K.  Primary Care Physician (PCPs) or Primary Care Sites (PCSs) Responsibilities.  The PCP or a physician in a PCS must serve as the participant's initial point of contact with the Contractor.  As such, the PCP's or the physician at the PCS, responsibilities include the following:
  1.  Delivery of medically necessary primary care services and preventive services, including DPSDT screening services;
  2.  Provision of 24 hour, 7 days a week coverage;
  3.  Referrals for specialty care and other medically necessary services covered in the Medicaid benefit package;
  4.  Continuity and coordination of the participant's health care; and
  5.  Maintenance of a current medical record for the participant, including documentation of all services provided by the PCP and specialty or referral services or out of plan services such as family planning and emergency room services.

Although PCPs must be given responsibility for the above activities, the Contractor must agree to retain responsibility for monitoring PCP actions to ensure they comply with the Contractor's and the state's requirements.

The Contractor is prohibited from imposing restrictions for the above activities.  The Contractor must agree to retain responsibility for monitoring PCP and PCS actions to ensure they comply with the Contractor's and the state's requirements."  Nevada Contract, pages 35-36.

NJ

"ARTICLE 10
COVERED HEALTH CARE SERVICES...
Subject to any limitations in the benefits package, each primary care physician shall provide health counseling and advice; conduct baseline and periodic health examinations; diagnose and treat covered conditions not requiring the referral to and services of a specialist; arrange for inpatient care, for consultation with specialists, and for laboratory and radiological services when medically necessary; coordinate referrals for dental care, especially in accordance with EPSDT requirements; coordinate the findings of laboratories and consultants…The primary care physician shall also be responsible, subject to any limitations in the benefits package, for determining the urgency of a consultation with a specialist and, if urgent, shall arrange for the consultations appointment…"  New Jersey Contract, pages 51-52.

"1.93  'Primary Care Physician' or 'PCP' means a licensed medical doctor (MD) or doctor of osteopathy (DO) who is responsible for providing all required primary care services to enrollees…coordination of overall medical care...and initiation of referrals to specialty providers described in this contract and the Benefits Package, and for maintaining continuity of patient care."  New Jersey Contract, page 20.

"HealthStart Maternity Care Services
OVERVIEW
   The primary objective of HealthStart maternity care services is to provide women in New Jersey with a comprehensive package of care which addresses all areas of their lives likely to affect their pregnancy outcomes and the health of their infants...
   The services are a 'package' in the sense that ONE primary provider…is responsible for coordinating all of the services and ensuring that they are delivered in the appropriate fashion...
   Certain principles have guided development of the program regulations and guidelines.  Stating these principles will assist the provider to implement the spirit as well as the requirements of the maternity care package.
  1.  The primary provider carries the RESPONSIBILITY for insuring that services are available, accessible, and that the client understands the need for and is supported to receive early and continuous maternity care.  In keeping with the principle, the provider is responsible for minimizing all potential barriers to services such as waiting time, language barriers, and physical distance and/or fragmentation…"  New Jersey Contract, Attachment 3, page 3.

NM

"2.C.2  The Primary Care Provider (‘PCP'):
The PCP must be a medical provider participating with the MCO who has the responsibility for supervising, coordinating, and providing primary health care to members, initiating referrals for specialist care, and maintaining the continuity of the member's care.  The CONTRACTOR shall distribute information to the network providers which explains the Medicaid-specific policies and procedures that relate to PCP responsibilities.  The CONTRACTOR is prohibited from excluding providers as primary care providers based on the proportion of high-risk patients in their caseloads...

2.C.3  Primary Care Responsibilities
The CONTRACTOR shall ensure that the following primary care responsibilities are met by the PCP, or in another manner:
2.C.3.a  Providing twenty-four (24) hour, seven (7) day a week access;
2.C.3.b  Ensuring coordination and continuity of care with providers who participate with the MCO network and with providers outside the MCO network according to MCO policy…

2.C.4  MCO Responsibility for PCP Services:
The CONTRACTOR  shall retain responsibility for monitoring PCP activities to ensure compliance with MCO and HSD policies.  The MCO shall educate PCPs about special populations and their service needs.  The CONTRACTOR shall ensure that PCPs successfully identify and refer patients to specialty providers as medically necessary." New Mexico Contract, pages 27-28.

NY

"21.  PARTICIAPTINGG PROVIDERS...
21.9  PCP Responsibilities
In conformance with the Benefit Package, the PCP shall provide health counseling and advice; conduct baseline and periodic health examinations; diagnose and treat conditions not requiring the services of a specialist; arrange inpatient care, consultation with specialists, and laboratory and radiological services when medically necessary; coordinate the findings of consultants and laboratories; and interpret such findings to the Enrollee and the Enrollee's family, subject to the confidentiality provisions of Section 20 of this Agreement, and maintain a current medical record for the Enrollee.  The PCP shall also be responsible for determining the urgency of a consultation with a specialist and shall arrange for all consultation appointments within appropriate time frames…"  New York Contract, pages 21-1-21-6.

ND

"Primary Care Provider (PCP)...
The duties of the primary care provider shall be attending to the enrollee's routine medical care, to supervise and coordinate all of the enrollee's health care, to determine the need for and initiate all referrals, and to determine who shall perform medical services and whether the medical service is to be performed."  North Dakota Contract, Attachment C, page 6.

OH

"E.  Service Delivery Specifications
1.  Primary Care Physician Responsibility...

Primary care physicians are required to:
*  Act as the case manager for their designated enrollees' overall care and participate in the development of a team approach to clinical care and case management.

*  Act as the referring physician for enrollees requiring access to a specialty service.

*  Coordinate emergency care, including care provided in hospital emergency departments, for enrollees.

*  During regular office hours, provide a telephone coverage system and on-site staffing capacity to:
  -  respond to enrollee's medical questions;
  -  determine enrollee care needs;
  -  respond to emergency inquiries; and
  -  set appointments or make referrals in accordance with the requirements specified in OAC rule 5101:3-26-031(D)..."  Ohio RFP, pages 14-15.

OK

"1.4  Definitions
Each of the following terms shall have the indicated meanings unless the context clearly requires otherwise: ...

59.  PRIMARY CARE PROVIDER (PCP) means the individual practitioner or team selected by, or assigned to a particular ENROLLEE to provide and coordinate all of the enrollee's primary care needs and to initiate and monitor referrals for specialized services when required…"  Oklahoma RFP, pages 5, 11.

"2.7  Provider Network...
2.7.2   Primary Care Providers
2.7.2.1  Responsibilities...
PCP responsibilities must include at least the following:
• Delivering medically necessary primary care services, including EPSDT screening services for children and adolescents;
• Making referrals for specialty care and other medically necessary services and coordinating wraparound services and
• Maintaining a current medical record for the member…"  Oklahoma RFP, page 32.

"2.7.4  Behavioral Health Access & Utilization Management...
The Health Plan agrees that PCP shall make appropriate referrals to behavioral health providers…"  Oklahoma RFP, page 36.

ORMH

"e. Physical Health Care Providers
Contractor shall coordinate with physical health care providers and Fully Capitated Health Plans as follows:
(1)  Consult and communicate with OMAP Member's physical health provider as Medically Appropriate and within laws governing confidentiality as specified in OAR 410-141-0180, Oregon Health Plan Prepaid Health Plan Recordkeeping.
(2)  Consult with, and provide technical assistance to, physical health care providers in the Service Area to help assure that mental disorders are identified early so that intervention and prevention strategies can begin as soon as possible.
(3)  Develop and implement methods of coordinating with FCHPs in order to assure access and appropriate coordination of services delivered to mutual OMAP Members, particularly OMAP Members with exceptional service needs.  Such coordination shall be conducted within laws governing confidentiality."  Oregon Mental Health Contract, page 18.

PA

"Primary Care Practitioner (PCP) — A specific physician, physician group, health center, or a CRNP operating under the scope of their licensure who has received an exception from the Department of Health, responsible for providing primary care services and locating, coordinating,
and monitoring other medical care and rehabilitative services on behalf of a recipient…"  Pennsylvania RFP, page xii.

"A.  DESCRIPTION OF THE HEALTHCHOICES PROGRAM...
2. Background
In contrast to the FFS system, managed care is provided through a health care delivery system in which a Primary Care Practitioner (PCP) or group of PCPs is responsible for providing, coordinating, and managing the health care needs of the individual patient. The PCP is responsible for facilitating access to specialty services when medically necessary and ensuring continuity of care. The PCP serves not only as the gatekeeper, but as the gate opener to health care services…"  Pennsylvania RFP, pages 1-2.

"G. DIFFERENTLY ACCESSED SERVICES...
The PCP is responsible for locating, coordinating, and monitoring all primary care and other medical and rehabilitation services on behalf of members.

The PCP must furnish primary care to members who are enrolled with them, and serve as gateopeners and gatekeepers for access to most other types of services, with the exception of vision care, dental care, the first prenatal visit to an appropriate specialist, such as an OB/GYN or nurse midwife, and family planning services…"  Pennsylvania RFP, page 49.

"I.  PROVIDER NETWORK...
3. Primary Care Practitioners (PCPs)

a. PCP Responsibilities...
The PCP must serve as the member's initial and most important point of contact regarding health care needs. As such, PCP responsibilities must include at a minimum:
•  Providing primary and preventive care and acting as the patient's advocate, providing, recommending, and arranging for care.
•  Maintaining continuity of each member's health care.
•  Making referrals for specialty care and other medically-necessary services, both in and out-of-plan.
•  Maintaining a current medical record for the member, including documentation of all services provided to the member by the PCP, as well as any specialty or referral services…"  Pennsylvania RFP, pages 63-65.

PABH

"2.  Coordination of Care
  a.  The MCO and the HealthChoices HMOs are required to develop and maintain written agreements regarding the interaction and coordination of services provided to recipients enrolled in the HealthChoices program…The written agreements should include, but not be limited to: ...
  3)  Exchange of relevant enrollment and health-related information among the MCO, the HMO, and primary care practitioner (PCP in accordance with federal and state confidentiality laws and regulations; (e.g., periodic treatment updates with identified primary and relevant specialty providers)...

  b.  The MCO must ensure through its provider contracts that its providers interact and coordinate services with the HMO/PCP in the project area.
  Both behavioral health clinicians and PCPs have the obligation to coordinate care of mutual patients.  Consistent with state and federal confidentiality laws and regulations, both must:
  1)  Ascertain the member's PCP or behavioral health clinician and obtain applicable releases to share clinical information.
  2)  Make referrals for social, vocational, education, or human services when a need for such service is identified through assessment.
  3)  Provide health records to each other, as requested.
  4)  Comply with the agreement between the MCO and HMO to assure coordination between behavioral and physical health care including resolution of any clinical dispute.
  5)  Be available to each other for consultation."   Pennsylvania Behavioral Health RFP, pages 50-51.

"f.  The MCO must work in partnership with the designated county municipal health department, and primary care practitioner as applicable, to ensure that conditions identified in accordance with Chapter 25, Disease Prevention and Control Law are reported (e.g., tuberculosis, hepatitis)."  Pennsylvania Mental health RFP, page 60.

"b.  The MCO must among the provider network through contracts which include the following provisions: ...
  8)  Requirements for coordination and continuity of care with HMOs and PCPs…"  Pennsylvania Behavioral Health RFP, page 62.

RI

"ARTICLE I:  DEFINITIONS...
1.22  PRIMARY CARE PROVIDER (PCP)
Primary Care Provider means the individual Plan Physician or team selected by, or assigned to the member to provide and coordinate all of the member's health care needs and to initiate and monitor referrals for specialized services when required..."  Rhode Island RFP, pages 1, 4.

"2.08.02  Primary Care Providers (PCP)s
2.08.02.01  PCP Responsibilities
Contractor agrees to have written policies and procedures for assigning every member to primary care provider (PCP), who has not chosen one at the time of enrollment.  The PCP must serve as the member's initial and most important point of interaction with the Health Plan network.  As such, PCP responsibilities must include at a minimum:
-  Serving as the member's primary care provider
-  Making referrals for specialty care and other medically necessary services, both in-and out-plan
-  Maintaining a current medical record for the member
-  Adhering to the EPSDT periodicity schedule for members under age 21
-  Referring members for case management services

Although PCPs must be given responsibility for the above activities, Contractor also agrees to retain responsibility for monitoring PCP actions to ensure they comply with the Contractor and RIte Care program policies...

2.08.02.03  PCP Teams
If Contractor primary care network includes institutions with accredited primary care residency training programs, it may use PCP teams, comprised of residents and a supervising faculty physician, to serve as a PCP.  Contractor shall organize its PCP teams so as to ensure continuity of care to members an must identify a 'lead physician' within the team for each member.  The 'lead physician' must be an attending physician and the physician who is accountable as the PCP.  Teams shall be small in size and team members shall be assigned for sufficient duration to maintain patient continuity.

2.08.02.04  PCP Sites
If Contractor's primary care network includes Federally Qualified Health Centers (FQHCs) or Rural Health Centers (RHCs), it may designate either type of site as a PCP.  In both instances, Contractor shall organize it PCP sites so as to ensure continuity of care to members and shall identify a 'lead physician' within the site for each member and the physician who is accountable as the PCP..."  Rhode Island RFP, pages 32-34.

SC

"4.8.3   Contractor's Network Composition...
4.8.3.1   Primary Care Providers (PCP)
A PCP in the Medicaid HMO Program must be a physician or network provider/subcontractor who provides or arranges for the delivery of medical services, including case management, to assure that all services which are found to be medically necessary are made available in a timely manner as outlined in § 4 of this Contract...

The PCP shall serve as the member's initial and most important point of interaction with Contractor's provider network. The PCP responsibilities shall include, at a minimum:

4.8.3.1.1  Managing the medical and health care needs of members to assure that all medically necessary services are made available in a timely manner;
4.8.3.1.2  Monitoring and follow-up on care provided by other medical service providers for diagnosis and treatment;
4.8.3.1.3  Providing the coordination necessary for the referral of patients to specialists and for the referral of patients to services that may be available through fee-for-service Medicaid.
4.8.3.1.4  Maintaining a medical record of all services rendered by the PCP and other referral providers."  South Carolina Contract, pages 24-25.

"Primary Care Provider (PCP) - The provider who serves as the entry point into the health care system for the member.  The PCP is responsible for including, but not limited to providing primary care coordinating and monitoring referrals to specialist care, authorizing hospital services, and maintaining the continuity of care."  South Carolina Contract, Appendix A, page 7.

TN

"Attachment I - Definitions...
40.  Primary Care Physician - a physician responsible for supervising, coordinating, and providing initial and primary care to patients; for initiating referrals for specialist care; and for maintaining the continuity of patient care.

41.  Primary Care Provider   - a primary care physician or registered  professional nurse or physician assistant practicing in accordance with state law who is responsible for supervising, coordinating, and providing initial and primary care to patients; for initiating referrals for specialist care; and for maintaining the continuity of patient care…"  Tennessee Contract, pages 90-95.

TX

"Primary care physician or primary care provider (PCP) means a physician or provider who has agreed with HMO to provide a medical home to Members and who is responsible for providing initial and primary care to patients, maintaining the continuity of patient care, and initiating referral for care (also see Medical home)."  Texas Contract, page 10.

"6.6  BEHAVIORAL HEALTH CARE SERVICES - SPECIFIC REQUIREMENTS…
6.6.7  HMO must require, through contract provisions, that PCPs have screening and evaluation procedures for detection and treatment of, or referral for, any known or suspected behavioral health problems and disorders.  PCPs may provide any clinically appropriate behavioral health care services within the scope of their practice.  This requirement must be included in all Provider Manuals.

6.6.8  HMO must require that behavioral health providers refer Members with known or suspected physical health problems or disorders to their PCP for examination and treatment.  Behavioral health providers may only provide physical health care services if they are licensed to do so.  This requirement must be included in all Provider Manuals."  Texas Contract, pages 38-39.

"7.8  PRIMARY CARE PROVIDERS…
7.8.11  HMO must require PCPs, through contract provisions or provider manual, to provide primary care services and continuity of care to Members who are enrolled with or assigned to the PCP.  Primary care services are all services required by a Member for the prevention, detection, treatment and cure of illness, trauma, disease or disorder, which are covered and/or required services under this contract.  All services must be provided in compliance with generally accepted medical and behavioral health standards for the community in which services are rendered.  HMO must require PCPs, through contract provisions or provider manual, to provide children under the age of 21 services in accordance with the American Academy of Pediatric recommendations and the THSteps periodicity schedule and provide adults services in accordance with the U.S. Preventive Services Task Force’s publication 'Put Prevention Into Practice.'

7.8.11.1  HMO must require PCPs, through contract provisions or provider manual, to assess the medical needs of Members for referral to specialty care providers and provide referrals as needed.  PCP must coordinate care with specialty care providers after referral.

7.8.11.2  HMO must require PCPs, through contract provisions or provider manual, to make necessary arrangements with home and community support services to integrate the Member’s needs.  This integration may be delivered by coordinating the care of Members with other programs, public health agencies and community resources which provide medical, nutritional, behavioral, educational and outreach services available to Members.

7.8.11.3  HMO must require, through contract provisions or provider manual, that the Member’s PCP or HMO provider through whom PCP has made arrangements, be the admitting or attending physician for inpatient hospital care, except for emergency medical or behavioral health conditions or when the admission is made by a specialist to whom the Member has been referred by the PCP.  HMO must require, through contract provisions or provider manual, that PCP assess the advisability and availability of outpatient treatment alternatives to inpatient admissions.  HMO must require, through contract provisions or provider manual, that PCP provide or arrange for pre-admission planning for non-emergency inpatient admissions, and discharge planning for Members.  PCP must call the emergency room with relevant information about the Member.  PCP must provide or arrange for follow-up care after emergency or inpatient care.

7.8.11.4  HMO must require PCPs for children under the age of 21 to provide or arrange to have provided all services required under Article 6.8 relating to Texas Health Steps, Article 6.9 relating to Perinatal Services, Article 6.10 relating to Early Childhood Intervention, Article 6.11 relating to WIC, Article 6.13 relating to People With Disabilities or Chronic or Complex Conditions, and Article 6.14 relating to Health Education and Wellness and Prevention Plans.  PCP must cooperate and coordinate with HMO to provide Member and the Member’s family with knowledge of and access to available services."  Texas Contract, pages 63, 65-66.

UT

"Q.  'Primary Care Provider' or 'PCP'...  PCPs are responsible for delivering primary care services, coordinating and managing Enrollees' overall health and, authorizing referrals for other necessary care."  Utah Contract, Attachment B, pages 2-3.

"8.  Mental Health Services
  When an Enrollee presents with a possible mental health condition to his or her CONTRACTOR primary care physician, it is the responsibility of the primary care provider to determine whether the Enrollee should be referred to a psychologist, pediatric specialist, psychiatrist, neurologist, or other specialist..."  Utah Contract, Attachment B, page 22.

UTMH

"7.  Coordination - The CONTRACTOR will provide access to a coordinated, comprehensive, and continuous array of needed services through coordination with other appropriate entities.
  a.  Medicaid Prepaid Mental Health Plan (PMHP) Enrollees may also be enrolled in another managed care plan, such as an HMO or primary care physician program, that will be responsible for directing the physical health needs of the individual.  The CONTRACTOR will coordinate the provision of covered mental health services with the Enrollee's HMO or primary care physician...
  b.  The CONTRACTOR will educate HMOs and primary care physicians on the diagnosis, treatment, and referral of behavioral health disorders commonly seen in primary care."  Utah Mental Health Contract, page 11.

VA

"ARTICLE I - DEFINITIONS...
Primary Care Provider (PCP) - A practitioner who provides preventive and primary medical care for eligible Medicaid and CMSIP recipients, and who certifies prior authorizations and referrals for all medically necessary specialty services…"  Virginia Contract, pages 7-11.

WA

"1.13  Primary Care Provider (PCP) means a participating medical provider who has the responsibility for supervising, coordinating, and providing primary health care to members, initiating referrals for specialist care, and maintaining the continuity of member care…"  Washington General Services, page 3

WV

"1. DEFINITIONS
As used throughout this contract, the following terms shall have the meanings set forth below...

Primary Care Provider (PCP) - a specific clinician responsible for coordinating the health care needs of certain enrollees…"  West Virginia Contract, pages 4-5.

"3.2.1   PCP Responsibilities
The PCP will be the MCP enrollee's initial and most important contact with the MCP. As such, PCPs must have at least the following responsibilities:
a)  Maintaining continuity of each enrollee's health care by serving as the enrollee's primary care provider;
b)  Providing 24-hour, seven day a week access;
c)  Making referrals for specialty care and other medically necessary services, both in-plan and out-of-plan;
d)  Maintaining a current medical record for the enrollee, including documentation of all services provided to the enrollee by the PCP, as well as any specialty or referral services;
e)  Adhering to the EPSDT periodicity schedule for enrollees under age twenty-one (21); and
f)  Following MCP established procedures for coordination of in-network and out-of-network services for Medicaid enrollees."  West Virginia RFA, page 15.