Family Care, Family Care Partnership, and PACE: Managed Care Organization Contracts
The contracts below explain what’s required of managed care organizations (MCOs). You can view generic versions of contracts on this web page. We customize contracts for each MCO.
Contracts
Family Care and Family Care Partnership contract
2024–2025
- Family Care and Family Care Partnership contract, effective January 1, 2025 (PDF)
- Family Care and Family Care Partnership contract (includes October 2024 and November 2024 amendments), effective January 1, 2024 (PDF)
- Family Care and Family Care Partnership contract (includes October 2024 amendment), effective January 1, 2024 (PDF)
- Family Care and Family Care Partnership contract, effective January 1, 2024 (PDF)
- Substantive changes from prior Family Care and Family Care Partnership contract (PDF)
- October 2024 Amendment (PDF)
- November 2024 Amendment (PDF)
Dual Special Needs (D-SNP) Medicare Advantage Health Plan contract
- Calendar year 2026: D-SNP contract, effective January 1, 2026 (PDF)
- Calendar year 2025: D-SNP contract, effective January 1, 2025 (PDF)
Program of All-Inclusive Care for the Elderly (PACE) contract
2024–2025
- PACE contract, effective January 1, 2025 (PDF)
- PACE contract, effective January 1, 2024 (PDF)
- Substantive changes from prior PACE contract (PDF)
Tribal agreement
Three-Party Agreement Between DHS, Tribal Nation, and Managed Care Organization (PDF)
Materials cited in the current contracts
- Family Care: Standard Definitions of Managed Care Terminology
- Guidelines for Service Dogs in Family Care and Family Care Partnership, P-01048 (PDF)
- MCO Provider Network Adequacy Policy, P-02542 (PDF)
- MCO Training and Documentation Standards for Supportive Home Care, P-01602 (PDF)
- MCO Quarterly Appeal Log, F-02466 (Excel)
- MCO Quarterly Grievance Log, F-02466A (Excel)
- Medicaid Standards for Certified 1-2 Bed Adult Family Homes, P-00638 (PDF)
- Restrictive Measures Guidelines and Standards, P-02572 (PDF)
- Restrictive Measures User Guide, P-02769 (PDF)
- State Reporting Requirements (PDF)
- Template Language MCOs are Required to Use in Grievance and Appeal Materials, F-02619
- Transition of Care Between Medicaid Programs or Between Agencies Within a Medicaid Program, P-02364 (PDF)
Adult Long-term Care Provider Management Project: all providers should enroll now to avoid disruptions in 2026
All adult long-term care waiver services providers and vendors must enroll with Wisconsin Medicaid through the ForwardHealth Portal by January 1, 2026. As of August:
- Supportive home care agencies can now start a provider enrollment application.
- Supportive home care agencies with an electronic visit verification (EVV)-only provider Medicaid ID can convert their EVV-only enrollment to full Medicaid enrollment (revalidate).
Time is running out to process provider enrollment applications before the new year. We need your help to get providers and vendors enrolled—here are some key resources:
- Check out the Provider Enrollment System for Adult Long-term Care Portal page. You’ll find recorded trainings about how to enroll and information on how to get started.
- Find a toolkit for managed care organizations, a toolkit for IRIS fiscal employer agencies, a toolkit for IRIS consultant agencies, and a toolkit for IRIS participants to help spread the word to providers.
- Stay updated by signing up for the Adult LTC Waiver Provider email list to get news and resources.
Please note: this requirement does not affect individual self-directed support or participant-hired workers.