Family Care, Family Care Partnership, and PACE: Managed Care Organization Contracts
The contracts below explain what’s required of managed care organizations (MCOs). You can view generic versions of contracts on this web page. We customize contracts for each MCO.
Contracts
Family Care and Family Care Partnership contract
2024–2025
- Family Care and Family Care Partnership contract, effective Jan. 1, 2024 (PDF)
- Substantive changes from prior Family Care and Family Care Partnership contract (PDF)
2022–2023
- Family Care and Family Care Partnership contract, effective Jan. 1, 2023 (PDF)
- Family Care and Family Care Partnership contract, effective Jan. 1, 2022 (PDF)
Dual Special Needs (D-SNP) Medicare Advantage Health Plan contract
Calendar year 2025: D-SNP contract, effective January 1, 2025 (PDF)
Calendar year 2024: D-SNP contract, effective January 1, 2024 (PDF)
Calendar year 2023: D-SNP contract, effective January 1, 2023 (PDF)
Program of All-Inclusive Care for the Elderly (PACE) contract
2024–2025
2022–2023
- PACE contract, effective Jan. 1, 2023 (PDF)
- PACE contract, effective Jan. 1, 2022 (PDF)
- January 2023 amendment (PDF)
Materials cited in the current contracts
- Family Care: Standard Definitions of Managed Care Terminology
- Guidelines for Adaptive Aids – Service Dogs, P-01048 (PDF)
- MCO Provider Network Adequacy Policy, P-02542 (PDF)
- MCO Training and Documentation Standards for Supportive Home Care, P-01602 (PDF)
- MCO Quarterly Appeal Log, F-02466 (Excel)
- MCO Quarterly Grievance Log, F-02466A (Excel)
- Medicaid Standards for Certified 1-2 Bed Adult Family Homes, P-00638 (PDF)
- Restrictive Measures Guidelines and Standards, P-02572 (PDF)
- Restrictive Measures User Guide, P-02769 (PDF)
- State Reporting Requirements for 2024 (PDF)
- Template Language MCOs are Required to Use in Grievance and Appeal Materials, F-02619
- Transition of Care Between Medicaid Programs or Between Agencies Within a Medicaid Program, P-02364 (PDF)
Adult Long-term Care Provider Management Project
Starting September 2024, adult long-term care waiver services providers must enroll with Wisconsin Medicaid through the ForwardHealth Portal. The Portal centralized enrollment system will comply with federal requirements and standardize, streamline, and automate the process. Please note, this change does not affect individual self-directed support and participant-hired workers.
Here’s how to get informed and stay in-the-know:
- Sign up to receive emails about the new Medicaid provider enrollment process.
- Visit the New Provider Enrollment System for Adult Long-term Care Portal page.
- New! Attend a townhall in July or August. See the presentation in English (PDF), Hmong (PDF), and Spanish (PDF).