September 22, 2015•Alerts
Your comments on Managed Long-Term Services and Supports “Concept Paper” are due by 5:00 p.m. on Friday, October 16!
Pennsylvania is proposing Managed Long-Term Services and Supports (MLTSS). In this new system, managed care companies (health insurance companies) would manage home and community-based services, physical health care, nursing facility care, and the Living Independence for the Elderly (LIFE) program. Click here for background information.
Managed Long-Term Services and Supports (MLTSS), Community HealthChoices, would include individuals with Medicaid-only coverage who receive or need Long-Term Services and Supports, and individuals with full Medicare and Medicaid coverage (dual eligibles), including those with and without Long-Term Services and Supports needs. MLTSS would not include Act 150 program participants, individuals receiving their services through the lottery-funded Options program, persons with intellectual/developmental disabilities (ID/DD) who receive services through the Department of Human Services Office of Developmental Programs, or residents of state-operated nursing facilities, including the State Veterans’ Homes.
In July, there was a public comment period for a Managed Long-Term Services and Supports (MLTSS) “Discussion Document.” Now, there is a public comment period for a MLTSS “Concept Paper.” Comments are due to the Department of Human Services by 5:00 p.m. on Friday, October 16.
To submit comments:
- By mail, address to: April Leonhard, Office of Long-Term Living Bureau of Policy and Regulatory Management, P.O. Box 8025, Harrisburg, PA 17105-8025.
- By e-mail, send your comments to: RA-MLTSS@pa.govand include “Community HealthChoices” in the subject line.
The “Concept Paper” is available in alternative formats. To request an alternative format, please call the Department of Human Services, Office of Long-Term Living at (717) 783-8412. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
According to the Department of Human Services and the Department of Aging (in a September 16 press release):
“The concept paper includes the following highlights:
- Coordinates physical health and Long-Term Services and Supports through Community HealthChoices (CHC) managed care organizations (CHC-MCO).
- Provides participants with a choice of two to five Community HealthChoices-Managed Care Organizations in each region.
- Includes value-based incentives to increase the use of home and community-based services and meet other program goals.
- Creates a system that allows Pennsylvanians to receive services in the community, preserves consumer choice, and lets consumers have an active voice in the services they receive.
- Standardizes measures of both program and participant-level outcomes to assess overall program performance and improve Community HealthChoices over time.
- Community HealthChoices-Managed Care Organizations will be accountable for most Medicaid-covered services, including preventive services, primary and acute care, Long-Term Services and Supports (home and community-based services and nursing facilities), prescription drugs, and dental services.
- Participants who have Medicaid and Medicare coverage (dual eligible participants) will have the option to have their Medicaid and Medicare services coordinated by the same Managed Care Organization.
- Behavioral health services continue to be provided through the behavioral health managed care organizations (BH-MCOs), but Community HealthChoices-Managed Care Organizations and BH-MCOs will be required to coordinate services for individuals who participate in both programs.”
“Feedback on may be submitted through October 16, 2015. The concept paper feedback will shape the November 2015 request for proposals (RFP) for Community HealthChoices-Managed Care Organizations. The RFP will be tentatively awarded in March 2016, contingent upon successful readiness reviews and negotiations. Community HealthChoices will go live in the Southwest region in January 2017, the Southeast region in January 2018, and the Northwest, Lehigh-Capital and Northeast regions in January 2019.”
Remember, your comments on the Managed Long-Term Services and Supports “Concept Paper” are due by 5:00 p.m. on Friday, October 16!
Chava Kintisch, Esquire
Director of Civic and Government Affairs
215-238-8070, extension 210 (voice)
Disability Rights Network of Pennsylvania
Offices in Harrisburg, Philadelphia, and Pittsburgh