Written Policies and Procedures

Each PACT provider must have and observe written policies and procedures that include (A) a statement of its philosophy and objectives and of the geographical area served; (B) an intake policy; (C) intake procedures, including criteria for client enrollment and procedures for multidisciplinary review of each individual referral; (D) treatment procedures including, but not limited to, development of the treatment plan, case assignment, case review, discharge planning, and follow-up on members who leave the program voluntarily or involuntarily; (E) a medication policy that includes prescription, administration, and monitoring data; (F) a referral policy, including procedures for ensuring uninterrupted and coordinated member care upon transfer; (G) recordkeeping policies, including what information must be included in each record, and procedures to ensure confidentiality; (H) personnel and management policies, including policies for hiring, training, evaluation, supervision and termination protocol for all staff; (I) a utilization review plan; and (J) explicit fee policies with respect to billing third-party payers, cancellation procedures, and fee reductions.