17.18.5.7 Conflict Free Care Management
According to the Centers for Medicare & Medicaid Services (CMS), care management services must be “conflict-free. ESC ensures effective and ethical management by:
- ESC only provides Support Coordination Services.
- ESC does not have any affiliates and/or subsidiaries or any financial interest in any other agencies.
- ESC Support Coordinators cannot be financially responsible for a participant.
- ESC Support Coordinators cannot be employed by any entity that is a provider of a person’s personal care services or any other direct services under the Community Care Program or Supports Program.
- ESC Staff cannot make financial or health decisions on the participant’s behalf; or hold a financial interest/relationship in any entity that is paid to provide care for the beneficiary.
- ESC will not share a participant’s information with another SCA for marketing or referral of services, even with the individual’s consent.