Model of Care Program
The Centers for Medicare & Medicaid Services (CMS) regulations require that health plans provide their Special Needs Plan provider network with information on their basic Model of Care. This applies to our Dual-Eligible Special Needs Plan (D-SNP) members who are eligible for both Medicare and Medicaid, and Chronic Needs members (C-SNP), who have one or more qualifying conditions.
We have included a self-study program that outlines the basic Model of Care requirements for our providers. Also included are frequently asked questions that outline other helpful information.
Every year, CMS requires us to educate providers who usually treat our SNP members about ʽOhana’s Model of Care.
Medicare Provider Expectations – Model of Care
ʽOhana asks that you join us in making sure we are giving the highest quality care possible to our SNP members by:
- Review the member care plans faxed to you by 'Ohana
a. Call 1-888-505-1201 for questions or to further discuss the care plan;
b. Please keep a copy of the updated care plan to review with the SNP member during the next office visit.
- Participating in the Interdisciplinary Care Team (ICT) for all SNP members and give feedback as appropriate.
We appreciate the quality care you provide our members and your support in our efforts to meet the CMS regulations regarding the SNP Model of Care.