Model managed care contracts

Model managed care contracts

The Apple Health (Medicaid) managed care contracts (for reference only) identify the requirements and guidelines managed care organizations (MCO) must follow when providing access to health care services.

Model contracts (for reference only)

• Apple Health integrated foster care contract (updated 7/1/23)
• Apple Health integrated foster care (IFC) - behavioral health services wrap-around contract (updated 7/1/23)
• Apple Health - Integrated Managed Care (IMC) contract (updated 7/1/23)
• Apple Health - Integrated Managed Care (IMC) - behavioral health services wrap-around contract (updated 7/1/23)

Model State Medicaid Agency Contract (SMAC)

The State Medicaid Agency Contract (SMAC) identifies the requirements and guidelines Medicare Advantage (MA) Health Plans must follow when serving the dual-eligible individuals, allowing care coordination between Medicare and Apple Health (Medicaid) services.

Model contract (for reference only)

• Model State Medicaid Agency Contract (SMAC) (effective January 1, 2023)

Model Behavioral Health Administrative Services Organization (BH-ASO) contracts

Model BH-ASO contracts (for reference only) identify the requirements and guidelines behavioral health administrative organizations must follow when providing access to behavioral health crisis services and supports to Medicaid and non-Medicaid individuals.

BH-ASO model contract

• Behavioral health administrative services organization contract (updated 7/1/23)

BH-ASO report template

• CBHEF quarterly expenditure report
• Co-responder report (new 7/1/23)
• CJTA quarterly progress report (update 7/1/23)
• Crisis housing voucher log (King only)
• Crisis stabilization center-diversion pilot  (Whatcom only)
• Crisis triage stabilization increasing inpatient report
• Crisis system metrics report
• Data shared with external entities report
• E&T Discharge planner report
• Enhanced mobile crisis response quarterly report (Beacon, King, and Spokane only)
• Enhanced mobile crisis response staff details (Beacon, King, and Spokane only)
• FBG annual progress report
• FYSPRT Gift card purchase and distribution tracker 
• Grievance adverse determination appeals
• Juvenile treatment court
• Mobile crisis report (updated 7/1/23)
• MHBG project plan
• Non-Medicaid expenditure report
• Non-Medicaid spending plan (new 7/1/23)
• Peer bridger monthly report
• Peer bridger participant treatment engagement report (updated 7/1/23)
• Peer pathfinder jail transition report log
• Recovery navigator program quarterly report
• SABG capacity management
• SABG project plan
• Supplemental data daily submission notification
• Supplemental data monthly certification letter
• Systems of care MRSS quarterly (Beacon/Pierce and Spokane)
• Trauma informed counseling services to children and youth (Whatcom only)
• Trueblood enhanced crisis stabilization quarterly report (King only)
• Trueblood enhanced crisis stabilization services staff details (King only)
• Trueblood enhanced crisis stabilization/triage quarterly report (Beacon and Spokane only)
• Trueblood enhanced crisis stabilization/triage services staff details (Beacon and Spokane only)
• Trueblood lifeline connections transportation log (Beacon only)
• Trueblood misdemeanor diversion fund report 
• Youth behavioral health navigator MDT monthly tracking (new 7/1/23)
• Youth behavioral health navigator quarterly report (new 7/1/23)