Family Care, Family Care Partnership, and PACE: Managed Care Organization Contracts
Managed care organizations (MCOs) sign contracts with Wisconsin Department of Health Services (DHS) for these programs:
The contracts explain what’s required of MCOs. You can view generic versions of contracts on this web page. We customize contracts for each MCO.
2022 contracts
These contracts were effective on Jan. 01, 2022:
- Dual-Eligible Special Needs Medicare Advantage Health Plan Contract (PDF)
- Family Care/Family Care Partnership Contract:
- PACE Contract (PDF)
Materials cited in the current contracts
- Family Care: Standard Definitions of Managed Care Terminology
- Guidelines for Adaptive Aids – Service Dogs, 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 for 2023 (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)
2020-2021 contracts
These contracts were effective on Jan. 01, 2020: