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
2026–2027
- Family Care and Family Care Partnership contract, effective January 1, 2026 (PDF)
- Substantive changes from prior Family Care and Family Care Partnership contract (PDF)
2024–2026
- 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)
- 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
2026–2027
2024–2025
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)
Medicaid payments will end March 31 for adult long-term care providers who do not submit a provider application immediately
All adult long-term care waiver services providers needed to submit an application to enroll or revalidate with Wisconsin Medicaid through the ForwardHealth Portal by December 31, 2025. Providers who choose not to apply will not get reimbursed by Wisconsin Medicaid for dates of service on and after April 1, 2026.
Providers who did not apply but want to keep delivering home and community-based services under one of Wisconsin’s adult long-term care waiver programs must apply immediately. Applications must be approved and contracts and services must be authorized before providers can be paid by Wisconsin Medicaid. This can take several weeks. Providers may see a lapse in payment if their application is not approved by March 31, 2026.
Key resources:
- Providers—learn how to apply on 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.
- Partners—use our toolkits to help spread the word to providers:
Please note: this requirement does not affect individual self-directed support or participant-hired workers.