SIGNED FINAL_MOU BETWEEN PRENATAL CARE COORDINATION (PNCC) PROVIDER AND DEAN HEALTH PLAN (DHP) HMO 4-16-2026

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,