(a) In this section, “patient-centered medical home” means a medical relationship:
(1) between a primary care physician and a patient in which the physician:
(A) provides comprehensive primary care to the patient; and
(B) facilitates partnerships between the physician, the patient, any acute care and other care providers, and, when appropriate, the patient’s family; and
(2) that encompasses the following primary principles:
(A) the patient has an ongoing relationship with the physician, who is trained to be the first contact for and to provide continuous and comprehensive care to the patient;
(B) the physician leads a team of individuals at the practice level who are collectively responsible for the patient’s ongoing care;
(C) the physician is responsible for providing all of the care the patient needs or for coordinating with other qualified providers to provide care to the patient throughout the patient’s life, including preventive care, acute care, chronic care, and end-of-life care;
(D) the patient’s care is coordinated across health care facilities and the patient’s community and is facilitated by registries, information technology, and health information exchange systems to ensure that the patient receives care when and where the patient wants and needs the care and in a culturally and linguistically appropriate manner; and
(E) quality and safe care is provided.
(b) The commission shall, to the extent possible, work to ensure that Medicaid managed care organizations:
(1) promote the development of patient-centered medical homes for recipients; and
(2) provide payment incentives for providers that meet the requirements of a patient-centered medical home.


Text of section effective on April 01, 2025

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