SIGNED FINAL MOU PNCC BETWEEN JEFFERSON COUNTY PRENATAL CARE COORDINATION PROVIDER AND DEAN HEALTH PLAN (DHP) HMO 2-23-2026

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 DHS 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.