The purpose of this Contract is to obtain the services of Contractor to manage the 1115 Behavioral Health Demonstration Waiver Program, the Healthy Michigan Plan and relevant approved Waivers in a designated service area and to provide a comprehensive array of specialty mental health and SUD services and supports as indicated in this Contract. This is a Capitated Rate Contract paid on a price-per eligible per month (PEPM) basis. Contractor must manage its responsibilities in a manner that promotes maximum value, efficiency, and effectiveness consistent with State and federal statute and applicable waiver standards. This includes limiting managed care administrative duplication thereby reducing avoidable costs while maximizing the portion of funds to be directed to beneficiary services. Contractor must actively manage behavioral health services for its awarded region using standardized methods and measures for determination of need and appropriate delivery of service. Contractor must ensure that cost variances in services are supported by quantifiable measures of need to ensure accountability, value and efficiency. Contractor is required to hold contracts with each Community Mental Health Services Program (CMHSP) in its region(s) and must minimize duplication of contracts and reviews for providers contracting with multiple CMHSPs in the service area.
