Passport implements new requirement for medically frail members

Effective July 1, 2018, Passport Health Plan has implemented a new requirement for medically frail members.

Some of our members may be considered medically frail, meaning that they are exempt from any cost-sharing and are automatically placed into Passport’s Care Management programs. A person may be determined as medically frail if they have a severe condition including, but not limited to:

  • Activities of Daily Living (physical, intellectual or developmental limitations such as with dressing, eating, etc)
  • Disabling mental disorder (including serious mental illness)
  • Chronic substance use disorder (SUD)
  • Chronic homelessness
  • Serious and complex medical conditions

Providers who think they have a patient who is a Passport member and might be classified as medically frail should first check the Passport Portal to determine if they have already been deemed medically frail via claims data or another provider attestation. If the member has not been deemed as medically frail, providers are asked to submit an attestation on the patient’s condition.

The attestation form is available online by clicking here. Providers can check the Medically Frail Condition Guide for more information.

Providers who have questions should call Passport Provider Services at 1-800-578-0775, or contact their Passport Provider Services Representative.