SIGNED FINAL MOU Between PNCC and Managed Health Services Insurance Corp. (MHS) 2-9-2026

MEMORANDUM OF UNDERSTANDING (MOU) BETWEEN PRENATAL CARE COORDINATION PROVIDER AND
Managed Health Services Insurance Corp and Network Health Plan (HMO)
INSTRUCTIONS
Prenatal Care Coordination (PNCC) services are paid fee-for-service by Wisconsin Medicaid and 
BadgerCare Plus for all members eligible to receive those services, 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 by the HMO. 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 a PNCC provider and HMOs in the PNCC service area. The MOU recognizes that the PNCC 
provider and the HMO have shared members and agree to cooperate and coordinate care. The MOU 
provides a framework for establishing a working relationship between both entities.

PERIOD OF AGREEMENT
This MOU will become effective on the date the PNCC provider has received written or published 
certification approval from the Wisconsin Department of Health Services (DHS). The MOU will remain 
in effect until either the HMO or the PNCC disenrolls from Medicaid or is terminated from 
ForwardHealth, unless either party terminates the MOU based on a breach of the MOU's 
responsibilities, listed below.

HMOs can confirm a PNCC provider's certification status by consulting DHS's weekly provider report.

If either party to this MOU terminates the MOU based on a breach of its terms, both parties are 
obligated to immediately notify the OHS Office of the Inspector General within 30 days of the 
termination date at DHSOIGAdmin@dhs.wisconsin.gov that the MOU has been terminated.

This MOU may be amended at any time by mutual agreement, with the changes noted in a signed and 
dated addendum to this document.