Wisconsin has three managed care programs under the umbrella of ForwardHealth that serve specific subsets of the Medicaid population. Family Care is a voluntary program that provides MLTSS to dual eligibles and Medicaid EBD individuals ages 18 years and over. Family Care plans operate as prepaid inpatient health plans (PIHPs) because they provide a limited set of benefits on a capitated basis. Family Care Partnership Medicare covers most acute services (which may include psychiatric care), while Medicaid, the payer of last resort, covers LTSS and non-physician behavioral health services.
This Wisconsin Medicaid Contract is for Community Care Health Plan, signed January 1, 2018.
For more information on Wisconsin’s Medicaid managed care programs, and to view other contracts, visit Wisconsin Medicaid Managed Care Contracts.