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Container
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Title
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2006/038
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Part 12 (2006/038): Additions, 1988-2002
7.2 cubic feet (6 records center cartons and 3 archives boxes) and 1 videorecording
: Records of two programs supervised by the bureau that provided health care services to Medicaid and some Medicare clients. The majority of the files date from the period 1997-2001. Documenting the HMO program there are recertification files containing general information about each HMO and particularly its internal quality improvement programs. A few files in this section concern the general HMO program and studies of user satisfaction and self-report data. The remainder of the accession concerns the Wisconsin Partnership Program (WPP), a program that served a select population consisting of frail elderly and disabled individuals in their homes. A subgroup of the WPP population were served through the federal (Program of All-inclusive Care for the Elderly (PACE) program, which was funded by a grant from the Robert Wood Johnson Foundation. The WPP files document relations with WPP health care providers (particularly Community Care Organizations of Milwaukee and Elder Care of Dane County). About the oversight function the records include contracts, financial reports, information on rates, and narrative performance audits. Other records are administrative in nature and are not confidential. The records also contain extensive files on the development of administrative policies, determination of rates, and interaction with EDS. The videotape is a 1993 presentation about the PACE care model by Elder Care of Dane County. Three boxes of AHSI
enrollment follow-up forms were not retained.
: Denials of care (non-enrollment) by providers were reviewed by the bureau and these files contain detailed information about the medical conditions and living situations of the individuals in question. These files are boxed separately in Boxes 8 and 9 and are confidential.
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HMO certification records, 1998-1999
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Box
1
Folder
1
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Access
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Box
1
Folder
2
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Atrium
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Dean Care
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Box
1
Folder
3
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General
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Box
1
Folder
4
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Quality improvement
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Box
1
Folder
5
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Publications, handbooks
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Box
1
Folder
6
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Family Health Plan
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Greater La Crosse Health Plans Inc.
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Box
1
Folder
7
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General
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Box
1
Folder
8
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Quality improvement
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Box
1
Folder
9
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Grievances
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Box
1
Folder
10
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Group Health
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Group Health of Eau Claire
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Box
1
Folder
11
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General
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Box
1
Folder
12
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Quality improvement report
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Box
1
Folder
13-14
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Humana
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Box
1
Folder
15-16
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Managed Care/Network
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Box
1
Folder
17-18
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MercyCare
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Box
1
Folder
19-20
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Physicians Plus
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Box
2
Folder
1-3
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PrimeCare
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Box
2
Folder
4-5
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Security
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Box
2
Folder
6-7
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Touchpoint (United)
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Unity Health Plans
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Box
2
Folder
8
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General
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Box
2
Folder
9
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Grievances
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Box
2
Folder
10
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Member materials
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Box
2
Folder
11
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Quality improvement
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Box
2
Folder
12-13
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Valley Health
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General HMO program files
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Box
2
Folder
14
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Dental health grant application, 2002
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Box
2
Folder
15
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EDS, 1997-2000
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Box
2
Folder
16
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Medical assistance HMO waiver, 1994
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Box
2
Folder
17
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Managed care conference, 1999
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Box
2
Folder
18
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Mental health/substance abuse audit, 1998
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Box
2
Folder
19
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Quality Improvement System for Managed Care
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Box
3
Folder
1-2
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Satisfaction survey, 2000
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Box
3
Folder
3-5
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Self reported data study
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Wisconsin Partnership Program records
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Access
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Box
3
Folder
6
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General
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Box
3
Folder
7
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Contract, 1996-1997
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Box
8
Folder
1
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Denials
: This folder is RESTRICTED.
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Box
3
Folder
8
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Payments
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Box
3
Folder
9
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Rates
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Box
3
Folder
10
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Subcontracts
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Box
3
Folder
11
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WPP proposal, 1994
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Center for Independent Living for Western Wisconsin (CILWW)
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Box
3
Folder
12
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Contract, 1998
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Box
8
Folder
2-4
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Denials
: This folder is RESTRICTED.
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CCO/CCE (Community Care Organization/Community Care for the Elderly)
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Box
3
Folder
13-15
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General
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Box
3
Folder
16
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Allegations, 1997
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Box
3
Folder
17
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Alzheimer's program, 1988
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Box
3
Folder
18
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Audit, 2000
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Box
3
Folder
19-26
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Contracts, 1995-2000
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Box
4
Folder
1
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Correspondence
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Box
4
Folder
2
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Data
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Box
8
Folder
4
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Denials
: This folder is RESTRICTED.
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Box
4
Folder
3-4
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Financial reports, 1992-1998
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Box
4
Folder
5
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Nursing home liability
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Box
4
Folder
6
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Quarterly reports
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Box
4
Folder
7
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Rates
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Box
4
Folder
8
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Risk adjustment
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Box
4
Folder
9
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Waiver, 1989
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Community Health Partnership (CHP)
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Box
4
Folder
10-11
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Audits
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Box
4
Folder
12
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Contract, 2000
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Box
8
Folder
6-13
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Denials, Grievances and, Appeals
: This folder is RESTRICTED.
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Box
4
Folder
13
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EDS
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Box
4
Folder
14
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Financial reports
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Box
4
Folder
15
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Followup review, 2000
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Box
4
Folder
16
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Miscellaneous
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Box
4
Folder
17
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Quality improvement
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Box
4
Folder
18
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Quarterly reports
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Box
4
Folder
19
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Retro adjustments
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Community Living Alliance (CLA)
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Box
4
Folder
20-21
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General
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Box
4
Folder
22
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Audit
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Box
4
Folder
23-24
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Contracts, 1998-2000
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Box
4
Folder
25
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Corrective actions
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Box
4
Folder
26
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Death investigation
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Box
9
Folder
1-7
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Denials, grievances, and appeals
: This folder is RESTRICTED.
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Box
4
Folder
27
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Payments
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Box
4
Folder
28
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Quarterly reports
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Box
4
Folder
29
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Quality improvement reports, 2001
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Elder Care of Dane County
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Box
4
Folder
30
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General
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Box
4
Folder
31
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Audit, 2000
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Box
4
Folder
32
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Census
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Box
4
Folder
33-34
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Contracts, 1995-1998
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Box
5
Folder
1-4
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Contracts, 2000
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Box
5
Folder
5
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Correspondence
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Box
5
Folder
6
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Cultural competency
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Box
9
Folder
8-13
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Denials and grievances
: This folder is RESTRICTED.
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Box
5
Folder
7
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EDS
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Box
5
Folder
8
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Expansion
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Box
5
Folder
9
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FFS (Fee For Service)
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Box
5
Folder
10
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Financial statements
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Box
5
Folder
11
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HCFA (Health Care Financing Administration), 1995-1996
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Box
5
Folder
12
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Hospice care
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Box
5
Folder
13
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Memorandum of understanding (MOU)
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Box
5
Folder
14
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Medicaid
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Box
5
Folder
15
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Meetings
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Box
5
Folder
16
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OCI (Organizational Conflict of Interest) waiver
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Box
5
Folder
17
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Program of All-Inclusive Care for the Elderly (PACE) phase out, 2001
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Box
5
Folder
18
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Payments
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Box
5
Folder
19
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Policy memos
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Box
5
Folder
20
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Publications and member materials
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Box
5
Folder
21-22
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Quality assurance/quality improvement
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Box
5
Folder
23
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Quarterly reports, 1997-1998
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Box
5
Folder
24-25
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Rates
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Box
5
Folder
26
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Report, 2000
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Box
5
Folder
27
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Requests for purchase
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Box
5
Folder
28
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Risk
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Box
5
Folder
29
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St. Mary's bill
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Box
5
Folder
30
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Studies
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Box
5
Folder
31
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Waivers
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Program development files
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Box
5
Folder
32-33
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General
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Box
5
Folder
34
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Adjustments
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Box
5
Folder
35
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Assessments, 2001
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Box
5
Folder
36
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BadgerCare demonstration, 1999
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Box
5
Folder
37
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Balanced Budget Act, 1998
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Box
5
Folder
38
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Bartels' speech, 1999
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Box
5
Folder
39
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Case management
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Box
5
Folder
40
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Client rights
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Box
5
Folder
41
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Conference, 1999
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Box
5
Folder
42-43
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Contract and drafts, 2001
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Box
5
Folder
44
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Data quality workgroup
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Box
5
Folder
45
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Demonstration operations manual
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Box
5
Folder
46
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EDS
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Box
6
Folder
1
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Eligibility
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Box
6
Folder
2
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Estate recovery
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Box
6
Folder
3
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First Health proposal
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Box
6
Folder
4
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Grievances
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Box
6
Folder
5
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HCFA
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Box
6
Folder
6
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Intergovernmental transfers
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Box
6
Folder
7-9
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Robert Wood Johnson grant
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Box
6
Folder
10
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MOU
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Box
6
Folder
11
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Managed care grant, 2000
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Box
6
Folder
12
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Management Group
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Box
6
Folder
13
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Management incentives
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Box
6
Folder
14
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Monitoring AIDS/Ventilator care
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Box
6
Folder
15
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Nursing home liability, 1996
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Box
6
Folder
16
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Onsite reviews
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Box
6
Folder
17
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PACE enrollment
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Box
6
Folder
18
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PACE evaluations
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Box
6
Folder
19
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PACE miscellany
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Box
6
Folder
20
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Policy memos
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Box
6
Folder
21-22
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Protocols, 1997-1998
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Box
6
Folder
23-26
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Quality assurance/quality improvement
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Box
6
Folder
27-33
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Rates, 1997-2001
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Box
7
Folder
1
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Rate setting
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Box
7
Folder
2
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Rate, miscellaneous
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Box
7
Folder
3
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Reimbursement
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Box
7
Folder
4
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Risk
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Box
7
Folder
5
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Special services
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Box
7
Folder
6
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Studies
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Box
7
Folder
7
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Team study
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Box
7
Folder
8
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VA proposal
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Box
7
Folder
9-10
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Waiver request and response
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Box
7
Folder
11
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Workgroup
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Box
7
Folder
12
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[unidentified material]
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