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2021-350-EMS-E-WellCare Health Plans of NC Inc-Medicaid managed care
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2021-350-EMS-E-WellCare Health Plans of NC Inc-Medicaid managed care
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Last modified
7/20/2021 11:32:10 AM
Creation date
7/20/2021 11:31:26 AM
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Contract
Date
6/30/2021
Contract Starting Date
6/30/2021
Contract Ending Date
7/1/2021
Contract Document Type
Contract
Amount
$770,000.00
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<br /> <br /> Page 18 of 48 <br />6.5.6 Provider or the applicable Contracted Provider shall notify WellCare of any change <br />in Provider’s or Contracted Provider’s key personnel, within 24 hours of such change. <br /> <br />6.6 Minimum Data Set. If Contracted Provider is a nursing facility, Provider or such Contracted <br />Provider shall submit to WellCare or its designee the Minimum Data Set as defined by CMS and required under <br />federal law and WellCare policy as it relates to all Covered Persons who are residents in Contracted Provider’s <br />facility. Such submission shall be via electronic mail, facsimile transmission, or other manner and format reasonably <br />requested by WellCare. <br /> <br />6.7 Quality Improvement Plan. Each Contracted Provider shall participate in WellCare’s LTSS <br />quality improvement plan. Each Contracted Provider shall permit WellCare to access such Contracted Providers’ <br />assessment and quality data upon reasonable advance notice, which may be given by electronic mail. <br /> <br />6.8 Electronic Visit Verification. If Contracted Provider provides in-home services, Contracted <br />Provider shall comply with 21st Century Cures Act and WellCare’s electronic visit verification system requirements <br />where applicable and accessible. <br /> <br />6.9 Criminal Background Checks. Provider shall conduct a criminal background check on each <br />Contracted Provider prior to the commencement of services under this Agreement and as requested by WellCare <br />thereafter. Provider shall provide the results of such background checks to WellCare and member, if se lf-directed, <br />upon request. WellCare within a reasonable time period following the completion thereof. Contracted Provider <br />agrees to immediately notify WellCare of any criminal convictions of any Contracted Provider. Provider shall pay <br />any costs associated with such criminal background checks. <br /> <br />7 Person-Centered Planning, Care/Service Plan, and Services. Provider and Contracted Providers shall <br />comply with all State and federal regulatory requirements related to person-centered planning, care/service plans, and <br />services including, but not limited to: <br /> <br />7.1 Covered Persons shall lead the person-centered planning process and can elect to include, <br />and/or consult with, any of their LTSS providers in the care/service plan development process. <br /> <br />7.2 The care/service plan must be finalized and agreed to, with the informed consent of the <br />individual in writing, and signed by all individuals and providers responsible for its implementation through the <br />mechanism required by State and federal requirements. Non-medical service providers (such as meals or assistive <br />technology) can signify their agreement through this contract or written agreement in lieu of directly in the plan, if <br />permitted by the Covered Person. <br /> <br />7.3 LTSS providers shall be aware of, respect, and adhere to a Covered Person’s preferences for <br />the delivery of services and supports. <br /> <br />7.4 LTSS providers shall ensure services and supports are culturally appropriate, provided in <br />plain language (where applicable), and accessible to Covered Persons and the person(s) supporting them who have <br />disabilities and/or are limited English proficient. <br /> <br />7.5 WellCare agrees to complete the care/service plan in a timely manner (within at least 120 <br />days of enrollment or annually, or less if State requirements differ) and provide a copy to LTSS provider(s) <br />responsible for implementation. <br /> <br />DocuSign Envelope ID: 2EC1F0FD-FAF9-4B42-B52E-D419F55A6210
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