SIGNED FINAL 6-9-2022 MOU Group Health Cooperative - Sauk County Health Depart. (PNCC)

MEMORANDUM OF UNDERSTANDING

Sauk County Health Department

And

Group Health Cooperative

For this Memorandum of Understanding (MOU) Sauk County Health Department is the Prenatal Care Coordination (PNCC) Provider and Group Health Cooperative is the Health Maintenance Organization (HMO)

INSTRUCTIONS

Prenatal Care Coordination (PNCC) services are paid fee-for-service by Wisconsin Medicaid and BadgerCare Plus for all members, including those enrolled in state-contracted HMOs. The PNCC provider may not determine the need for specific medical care, or make referrals directly to providers of medical care, for services covered under the HMO contract. The HMO is responsible for managing the member’s overall care. The HMO and the PNCC provider agree to facilitate inter-agency communication and inform staff from both the HMO and the PNCC agency about the policies and procedures for this cooperation, coordination, and communication.

PURPOSE AND SCOPE

Wisconsin Medicaid and BadgerCare Plus require the establishment of a memorandum of understanding (MOU) between PNCC providers and HMOs. The MOU recognizes that the PNCC agency and the HMO have “clients-in-common” and agree to cooperate in removing access barriers, coordinating care, and providing culturally competent services. The MOU provides a framework for establishing a working relationship between both entities.