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

Family Care and Family Care Partnership contract, effective Jan. 1, 2024 (PDF)
Substantive changes from prior Family Care and Family Care Partnership contract (PDF)

Family Care and Family Care Partnership contract, effective Jan. 1, 2023 (PDF)
Family Care and Family Care Partnership contract, effective Jan. 1, 2022 (PDF)

Dual Special Needs (D-SNP) Medicare Advantage Health Plan contract

Program of All-Inclusive Care for the Elderly (PACE) contract

PACE contract, effective Jan. 1, 2024 (PDF)
Substantive changes from prior PACE contract (PDF)

PACE contract, effective Jan. 1, 2023 (PDF)
PACE contract, effective Jan. 1, 2022 (PDF)
January 2023 amendment (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 2024 (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—enrollment now open!

As of September 16, 2024, adult long-term care waiver services providers must enroll with Wisconsin Medicaid through the ForwardHealth Portal. The Portal centralized enrollment system complies with federal requirements and standardizes, streamlines, and automates the process. Please note, this change does not affect individual self-directed support and participant-hired workers.

Here’s how to get started:

Find information about the enrollment process in the Family Care, Family Care Partnership, PACE, and IRIS program areas of the ForwardHealth Online Handbook.
Attend a live virtual training on Zoom to understand how to enroll. Check out the Live Training Schedule (PDF).
Sign up for the Adult LTC Waiver Provider email subscription list to get training registration links by email.
Find training recordings on the Trainings page of the Portal under the Adult Long-Term Care Programs menu.
Visit the New Provider Enrollment System for Adult Long-term Care Portal page for more information.