Federal definition of case management services
In Medicaid Definition of Covered Case Management Services Clarified, second paragraph, case management consists of services which help beneficiaries gain access to needed medical, social, educational and other services. “Targeted” case management services are those aimed specifically at special groups of enrollees such as those with developmental disabilities or chronic mental illness.
As stated further on, case management services are comprehensive and coordinated and will include an assessment of an eligible individual, development of a specific care plan, referral to services, and monitoring and follow-up activities.
Compare the graphic with the bolded CMS definitions:
- Assessment of an eligible individual to determine service needs
- Development of a specific care plan (Minnesota’s Individual Community Support Plan)
- Referral and related activities to help an individual obtain needed services, including activities that help link the eligible individual with medical, social, educational providers or other programs
- Monitoring and follow-up activities, including activities and contacts that are necessary to ensure that the care plan is effectively implemented and adequately addresses the needs of the eligible individual