Wednesday, November 18, 2009

Care Select Update

A representative of Family Voices attended the Care Select advisory council Tuesday. You may remember that when Care Select was rolled out approximately a year ago, there were some concerns voiced by families with children with a Medicaid waiver because many families have those children on their private insurance as well. There was often a conflict between meeting the in-network requirements for a doctor for private insurance versus trying to choose a PMP (Primary Medical Provider) in the Care Select care management organization (CMO). Family Voices worked on a sub committee to try to work out a plan for these families and individuals. These members were not auto-enrolled in Care Select when the rest of the 70,000 members chose PMP's.

However, Indiana’s Office of Medicaid Policy and Planning is revisiting those cases at the present time. It is their hope to enroll everyone, including this group, in Care Select with a PMP, and either Advantage or MdWise as the care management organization (CMO). Letters will be sent to families and individuals on Home and Community Based Services waivers beginning December 1, 2009, asking them to choose a PMP and CMO in the Care Select program. Another letter will be sent after January 1, 2010, reminding families and individuals to make a choice. The current plan is to auto-enroll anyone who has not chosen a PMP and CMO by February 1, 2010.

Once letters are finalized and released, we will share them via Family Voices. IPMG and case managers for the A&D and TBI waivers will be given info as well and will act as a resource to assist families and individuals with the process.

Steps to Care Select:
• You should ask if your preferred primary care physician is enrolled with Care Select. You can also find a list here:
o If they are, you will need to simply select that provider. If they are enrolled in BOTH Advantage and MDWise you can choose the CMO as well.
• Before you choose a Care Management Organization (Advantage and/or MDWise) you are encouraged to call and speak with their member services department to get information about the different organizations..
o If they are only enrolled in one CMO, you must choose that CMO.
• If your preferred Doctor is not enrolled, you can share who that physician is and ask that MD Wise and Advantage try to enroll that doctor.
o Calling soon will allow time for Advantage and/or MD Wise to try to enroll your current doctor.
• If your doctor chooses not to enroll you may need to select a new doctor (calling early will give you time to research who will be a good fit for you).

You can learn more about Care Select here:

and view a previous presentation here:

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