Yes, the practice is still meeting this requirement..
No, the practice is no longer meeting this requirement..
Partners with MaineCare members and care teams members to create care plans that support members’ needs. Use shared-decision aids and consider members’ health literacy levels in assessment and care planning. Include both clinician and patient action plans in the care plan as clinically appropriate.
Engage in coordination with any external care coordinator, case manager, discharge planners, or care team of the MaineCare member, as determined appropriate by the needs of the member, in accordance with all applicable state and federal privacy laws and best practices to support the member’s care goals.
Connects members to needed assessments including, but not limited to, Medical Eligibility Determination (MED) assessments for long-term care needs. (For more information on MED, please visit: https://www.maine.gov/dhhs/oads/providers/medical-eligibility-determination)
Provides member care transition services between healthcare providers and settings, including pediatric-to-adult care, to ensure continuity of care and reduce emergency department (ED) use and inpatient admissions, readmissions, and lengths of stay.
Ensures the provision of age-appropriate screenings, delivers screening-related services, and develops follow-up plans based on results, including but not limited to required blood lead level screening for all children at one year of age and two years of age per Maine Public Law, American Academy of Pediatrics/Bright Futures recommended screenings. (For more information regarding these recommended screenings, please visit: https://www.aap.org/en/practice-management/bright-futures/bright-futures-materials-and-tools/bright-futures-guidelines-and-pocket-guide/)
Ensures children under age 21 enrolled in MaineCare and Children’s Health Insurance Program (CHIP) are afforded Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefits in order to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not such services are covered under the Maine Medicaid State Plan. (For more information regarding EPSDT, please visit: https://www.maine.gov/dhhs/oms/providers/childrens-services.)
Has a documented (and implemented) process to routinely perform Screening, Brief Intervention, and Referral to Treatment (SBIRT) for members.
Offers topical fluoride varnish for members under age 21 in accordance with MaineCare Benefits Manual, Chapter II, Section 90.04-30. (For information regarding implementation of this requirement, please visit https://www.fromthefirsttooth.org)
Offers all appropriate immunizations to each member in accordance with the Centers for Disease Control and Prevention/ Advisory Committee on Immunization Practices immunization schedule. (For more information, please visit: https://www.cdc.gov/vaccines/acip/recommendations.html
Provides or provides referrals for all MaineCare covered United States Preventive Services Task Force (USPSTF) recommendations with a Grade of A or B. (For more information regarding the USPSTF recommendations, please visit: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations.)
Offers or refers to advanced care planning and palliative care consultation for members who may benefit from this service.
Utilize a Certified Electronic Health Record (CEHR).
As appropriate and at a minimum of once biennially, educate members about the appropriate use of office visits, urgent care clinics, and the Emergency Department (ED).
Agree to participate in MaineCare PCPlus Technical Assistance (TA) and quality improvement initiatives? (The Department will not require more than eight hours of practice participation annually.)
