Managed Care and Developmental Disability Services in Louisiana
|
|
|
- Arabella Hudson
- 3 years ago
- Views:
Transcription
1 Managed Care in LTSS and Developmental Disability Services: The Family Perspective Presented by: Karen Scallan, CPSP Special Needs & Parent Support Services of LA, LLC
2 SNAPSS of LA, LLC Special Needs & Parent Support Services of LA, LLC Certified in providing support and advocacy services to individuals and families of individuals with disabilities. One of only 2 CPSPs in Louisiana Assisting families in complex health or benefit issues. System Change Advocacy. Statewide. Karen Scallan, CPSP Special Needs & Parent Support Services of LA, LLC Certified Parent Support Provider Phone: kcscallan@gmail.com Facebook: Karen Scallan Blog: 2
3 Objectives Provide an understanding of what managed long-term supports and services (MLTSS) means. Provide an understanding of the opportunities for advocacy around MLTSS for individuals and their families. Provide a better understanding of the parent perspective around MLTSS. 3
4 What is LTSS/MLTSS? LTSS is Long-Term Supports and Services. It includes nursing home services, home and community based services, institutional care. MLTSS is Managed Long-Term Supports and Services applying managed care techniques to LTSS. MLTSS umbrella could include other services though! 4
5 Why Manage LTSS? Cost savings (?) Cost predictability for states. Improved outcomes (?) Meeting increased demand (?) In LA developmental disability waiver services are lean. Cost savings will come from institutional care (nursing facilities, ICF/DDs) and un-managed medical care. ICF/DD= Intermediate Care Facility for Individuals with Developmental Disabilities 5
6 Louisiana s Process Louisiana issues Request for Information La Department of Health & Hospitals (DHH) invited potential MCOs to present. DHH started the MLTSS Advisory Group. MLTSS Advisory Group met several times and continues to meet. Office for Citizens with Developmental Disabilities (OCDD) is making changes to correct current problems in the system before MLTSS is implemented. (System Transformation Workgroup including families). MCOs= Managed Care Organizations 6
7 Louisiana s Process Meetings of MLTSS Advisory Group tackled (via sub groups) Choosing our Partners Focusing on Providers Rebalancing Implementation Benefit Design Care Coordination Enrollment Populations Accountability Consumer Protections Measuring Quality and Outcomes RFP Development and Procurement Stakeholder Engagement and Communication 7
8 Concerns for Families: Managed Care for Developmental Disability Services MCOs are predominantly experienced in managing medical care; Most MCO experience in MLTSS is with individuals who are elderly; MCOs have little to no experience with individuals with intellectual or developmental disabilities (I/DD). 8
9 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will address this by a using a 2-Phase approach to build capacity, knowledge, and abilities of the MCO to work with Individuals with intellectual and developmental disabilities. 9
10 Concerns for Families: Managed Care for Developmental Disability Services MCOs will have to address quality of life measures, not just quality of health care. MCOs must address Employment services for waiver recipients. MCOs must preserve of selfdetermination of individuals and self-direction programs. 10
11 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will include performance improvement projects in the MLTSS contract one of which will be an employment initiative 11
12 Concerns for Families: Managed Care for Developmental Disability Services Reduction of providers available after any willing provider clause expires. National Association of State Directors of Developmental Disability Services & HSRI Guidebook on Managed care and Developmental Disabilities regarding a 1996 program of managed care for elderly individuals in Minnesota. the task for long-term care providers will be to position themselves to offer services which can substitute for acute care services and/or provide the expertise and resources needed to meet the needs of MCOs as they expand the services covered in their capitations in response to purchasers such as state and federal governments or retirement plans." 12
13 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will Include an LTSS Any willing provider clause for Yr 1; Set rates year 1; Set rate floors. 13
14 Concerns for Families: Managed Care for Developmental Disability Services New managed care practice of Network Narrowing Not all because they did not met health outcomes Physicians on high end of the usual and customary scale were dropped, despite high outcomes for patients What does Network Narrowing mean to those with complex health care needs Just because there is a urologist in the network does not mean that urologist understands complex urologic problems associated with individuals with Spina Bifida. 14
15 Concerns for Families: Managed Care for Developmental Disability Services Care coordination of significantly medically involved individuals and individuals with dual-diagnoses. Will care coordination = reduction of services, denials of care? 15
16 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will Include a flexible care coordination team with an experienced I/DD care coordinator for LTSS with a secondary care coordination for acute care and behavioral health. 16
17 Concerns for Families: Managed Care for Developmental Disability Services INCLUDING EARLY INTERVENTION in MLTSS: Educational model, not medical Services provided in natural settings, not clinical Funding from US Department of Education Congressional intent: to reduce costs to school districts Required education components of pre-literacy, school readiness, language, and numeracy. 17
18 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will Include all early intervention services in MLTSS But not in a capitation rate system Included administratively (i.e., handling paperwork, but not managing care 18
19 Concerns for Families: Managed Care for Developmental Disability Services Elimination of Waiver Waiting lists Discussion MUST include BOTH increase in funding for HCBS AND RETENTION OF CURRENT ELIGIBILITY REQUIREMENTS Independent Consumer Education and Meaningful Information Medical limits and other details of plans TRUE Person-Centered planning 19
20 Concerns for Families: Managed Care for Developmental Disability Services Language Concerns Multiple Language Translation of ALL materials Multiple Translations on web sites Meaningful web sites Audio files reading info on websites 20
21 Concerns for Families: Managed Care for Developmental Disability Services What assessment will be used to determine level of need? Who will conduct the assessment? LA uses SIS/LA Plus--Probably won t be used for long. Costing more and more each year Push for state-required assessment No arbitrary or varying MCO assessments 21
22 Concerns for Families: Managed Care for Developmental Disability Services Louisiana will Develop a life-span assessment Which will be administered by a third party, non-risk by the MCO 22
23 Concerns for Families: Managed Care for Developmental Disability Services Expansion of provider network for current services with inadequate networks. Exemptions to requirements for in network providers when continuity of care is essential. Care in the least restrictive environment a top priority while preserving choice and selfdetermination. 23
24 LA s MLTSS Advisory Group Recommendations MCOs and State invest in quality monitoring staff. Ombudsman Program in addition to an External Quality Review contract (EQR)* Independent surveys of quality Individuals with disabilities and Family Members as components of MCO advisory panel and on care coordination teams All payments to MCOs tied to quality measures. 24
25 LA s MLTSS Advisory Group Recommendations Louisiana will Include an independent Ombudsman contract in the MLTSS program Provide for independent surveys of quality by OCDD or an independent contractor 25
26 Ombudsman v. EQRO Ombudsman Independent Contract vital to solving urgent issues In-the-moment Data collection Anecdotal stories supporting data Can drive system change and advocacy initiatives EQRO External Quality Review (EQR) Required by Medicaid Main purpose to conduct analysis and evaluation of aggregated info on quality timelines, and access to health care services that an MCO or PHP or their contractors furnish to Medicaid recipients. 26
27 Recommendations by Louisiana s MLTSS Advisory Group Readiness Assessment MCO network adequacy the state s ability to support the MCO and providers, provider adequacy to meet technology and other requirements. Flexible Care Coordination allowing for different care coordination leader, (family, physician, psychologist) and innovation should be sought out for a selfdirected care coordination model. 27
28 Recommendations by Louisiana s MLTSS Advisory Group Louisiana will include a comprehensive readiness assessment of all systems in MLTSS Care coordination.not sure yet what it will exactly look like. 28
29 A lot to take in 29
30 The Devil Will Be in the Details. 30
31 MLTSS and Louisiana Parent Perspective on MLTSS: 31
32 Questions?
Timeline for Developing a Managed Long Term Services and Supports (MLTSS) Program
Timeline for Developing a Managed Long Term Services and Supports (MLTSS) Program May 2013 Prepared by Truven Health Analytics for the Centers for Medicare & Medicaid Services (CMS), Disabled and Elderly
UPDATE ON THE DEVELOPMENT OF MANAGED LONG-TERM SUPPORTS AND SERVICES IN LOUISIANA
UPDATE ON THE DEVELOPMENT OF MANAGED LONG-TERM SUPPORTS AND SERVICES IN LOUISIANA APRIL 2014 Developing a System of Managed Long-Term Supports and Services in Louisiana Long Term Supports and Services
Nebraska Medicaid Managed Long-Term Services and Supports
Background A significant shift in the management and administration of Medicaid services has taken place over the past several years with the growth of managed care. Full-risk managed care is a health
Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term
![Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term](/thumbs/30/14491472.jpg "Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term")
Arrangement between state Medicaid programs and managed care plan through which plan receive capitated payments [monthly amount] for long term services and supports (LTSS), including both home- and communitybased
The Arc of Texas 84th Legislature Priorities
The Arc of Texas 84th Legislature Priorities Long Term Services and Supports (LTSS): Ensure that all state funding and policies for LTSS for persons with intellectual and developmental disabilities (I/DD)
Guidance to States using 1115 Demonstrations or 1915(b) Waivers for Managed Long Term Services and Supports Programs
Guidance to States using 1115 Demonstrations or 1915(b) Waivers for Managed Long Term Services and Supports Programs 05/20/2013 version 1.0 I. Introduction States are increasingly incorporating populations
New Hampshire Department of Health and Human Services. Medicaid Care Management Program Step 2 Design Concept
New Hampshire Department of Health and Human Services Medicaid Care Management Program Step 2 Design Concept Redesign of New Hampshire s Long Term Services and Supports Delivery System: A Concept Paper
SB 7 Redesign of IDD Services and Supports 5.27.13 Brief
SB 7 Redesign of IDD Services and Supports 5.27.13 Brief Article 1. Delivery System Redesign for Provision of Acute Care Services and Long-term Services and Supports to Individuals with Intellectual and
Summary of Florida s Long Term Care Managed Care Program
MARCH 2013 Summary of Florida s Long Term Care Managed Care Program Table of Contents The Long Term Care Managed Care Program... 2 Waiver Application History... 3 Eligibility... 3 Enrollment... 4 Consumer
ANCOR Comments Medicaid Managed Care Regulations July 27, 2015
ANCOR Comments Medicaid Managed Care Regulations July 27, 2015 Andy Slavitt Acting Administrator Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services Attention: CMS-2390-P
Health Care Policy Legislative Oversight Committee
Health Care Policy Legislative Oversight Committee Mikki Stier, Medicaid Director November 3, 2015 Goal/Design MCO Status Member Update Provider Update Oversight MCO financing Administrative Rules Overview
Amendment #27: Employment and Community First CHOICES TennCare II demonstration (No. 11-W-00151/4) Table of Contents
Amendment #27: Employment and Community First CHOICES TennCare II demonstration (No. 11-W-00151/4) Table of Contents PART I: A Detailed Description of the Amendment, Including Impact on Beneficiaries Program
Medicaid and Employment
Medicaid and Employment Opportunities for Systems Change and Successful Employment Outcomes for People with Disabilities Nancy Kirchner Colleen Gauruder Disabled and Elderly Health Programs Group 1915
Managed Long-Term Services and Supports & Family Caregivers
Managed Long-Term Services and Supports & Family Caregivers Tues, September 1, 2015 2:30 3:45 p.m. Wendy Fox-Grage, moderator Follow: @AARPpolicy @LTSSpolicy Why Support for Family AARP Public Policy Institute
Challenges and Opportunities in Designing and Implementing an Integrated Medicaid Managed Long-Term Care Program. What is the. program?
Challenges and Opportunities in Designing and Implementing an Integrated Medicaid Managed Long-Term Care Program What is the program? The Long Term Care Community Choices Act of 2008 A law passed unanimously
Pennsylvania s Community HealthChoices Program
Pennsylvania s Community HealthChoices Program CONCEPT PAPER September 16, 2015 Your feedback is requested. This document contains the commonwealth s design for Community HealthChoices (CHC). The commonwealth
La Casa, Inc. Waiver Eligibility
La Casa, Inc. Waiver Eligibility Eligibility for Medicaid is determined by local Departments of Social Services. Income and resource thresholds must be met to be eligible for Medicaid. These thresholds
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Colorado As of July 2003, 377,123 people were covered under Colorado s Medicaid and SCHIP programs. There were 330,499 enrolled in the
Commonwealth of Pennsylvania MANAGED LONG-TERM SERVICES AND SUPPORTS (MLTSS) DISCUSSION DOCUMENT
Commonwealth of Pennsylvania MANAGED LONG-TERM SERVICES AND SUPPORTS (MLTSS) DISCUSSION DOCUMENT June 2015 June 1, 2015 Dear Fellow Pennsylvanian: Today we are beginning a very important process that will
July 15, 2015. Dear April Leonhard:
July 15, 2015 April Leonhard Department of Human Services Office of Long Term Living, Bureau of Policy and Regulatory Management P.O. Box 8025 Harrisburg, PA 17105-8025 Dear April Leonhard: Thank you for
EQR PROTOCOL 6 CALCULATION OF PERFORMANCE MEASURES
OMB Approval No. 0938-0786 EQR PROTOCOL 6 CALCULATION OF PERFORMANCE MEASURES A Voluntary Protocol for External Quality Review (EQR) Protocol 1: Assessment of Compliance with Medicaid Managed Care Regulations
shared with, and maintained by all providers and the MCO, PIHP, or PAHP that is coordinating the
CMS-2390-P 158 shared with, and maintained by all providers and the MCO, PIHP, or PAHP that is coordinating the care. Therefore, we propose to add standards in new paragraphs (b)(3) and (b)(5) that each
Frequently Asked Questions and Answers: Managed Care Organizations and HCS/TxHmL Program Providers
Frequently Asked Questions and Answers: Managed Care Organizations and HCS/TxHmL Program Providers Pharmacy/Medication Related Questions: 1) Question: After the initial transition pre-authorization period,
The report is based on four data sources. As in previous years, most data were from the CMS Form 64 reports, quarterly expense reports states submit
Thank you for joining the webinar today. We will discuss this year s report on Medicaid expenditures for long-term services and supports. I m Steve Eiken, a Senior Research Leader for Truven Health Analytics
Minnesota Case Management Reform
Minnesota Case Management Reform Chemical and Mental Health Services Administration- Adult and Children s Mental Health Divisions Continuing Care Administration Disability Services Division February 2014
Description of Transition Coordinator Role and Transition Process for Moving Home Minnesota
Bulletin February #14-69-02 28, 2014 Minnesota Department of Human Services -- P.O. Box 64941 -- St. Paul, MN 55164-0941 OF INTEREST TO Social Services Directors, Supervisors and Staff County Public Health
Stakeholder Workgroup Series Services and Supports: Final Recommendations
Stakeholder Workgroup Series Services and Supports: Final Recommendations I. Purpose/Goal Overall Goal: To solicit recommendations from external stakeholders for the development of state contract procurement
Expanding Self Direction in Ohio s Medicaid HCBS Programs
Expanding Self Direction in Ohio s Medicaid HCBS Programs The Executive Budget as introduced (HB 64) increases access to Medicaid home and community based services (HCBS), and creates new opportunities
Report of the Task Group on Conflict Free Case Management
Report of the Task Group on Conflict Free Case Management October 31, 2014 Submitted to: Colorado Department of Health Care Policy & Financing Division for Intellectual & Developmental Disabilities Conflict
RECENT STATE INITIATIVES IN REBALANCING LONG-TERM CARE
A Guide to Long-Term Care for State Policy Makers RECENT STATE INITIATIVES IN REBALANCING LONG-TERM CARE Reaching a more equitable balance between the proportion of total Medicaid long-term support expenditures
Restructuring Medicaid for Managed Long Term Services and Supports
Restructuring Medicaid for Managed Long Term Services and Supports New Jersey Hospital Association April 23, 2014 Deputy Commissioner Lowell Arye Department of Human Services 1 Backdrop for Move to MLTSS
Center for Health Care Strategies, Inc.
CHCS Center for Health Care Strategies, Inc. Technical Assistance Brief Developing Provider Networks for Medicaid Managed Long-Term Services and Supports Programs: Considerations for States By Julie Klebonis
August 26, 2013 (202) 690-6145. CMS and New York Partner to Coordinate Care for Medicare-Medicaid Enrollees
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations
Department of Human Services Response to Questions Submitted Regarding the MA LTC Access Study Posted February 21, 2012
Background The Minnesota Department of Human Services (the Department) issued a Request for Proposals (RFP) on January 17, 2012 for A Qualified Contractor(s) to conduct an Evaluation and Develop Dashboard
Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Application of Existing External Quality Review
Washington State Department of Social and Health Services
Report to the Legislature Plan for Integrated Managed Health and Mental Health Care for Foster Children Strategies and Timelines Second Substitute Senate Bill 6312, Section 110 Chapter 225, Laws of 2014
Introducing the National Core Indicators for Aging and Disability Services
Introducing the National Core Indicators for Aging and Disability Services 2 NCI-AD: Why and What Introduction 3 Joint project of the National Association of States United for Aging and Disabilities (NASUAD),
CONFLICT FREE CASE MANAGEMENT. Susan Fout October 30, 2014TE
CONFLICT FREE CASE MANAGEMENT Susan Fout TE Introduction History Targeted Case Management - Review Conflict Free Case Management Definition Policy What is the problem & Questions to consider Potential
Johnson County Community Developmental Disabilities Organization (CDDO)
Johnson County Community Developmental Disabilities Organization (CDDO) What is the CDDO? Johnson County Developmental Supports (JCDS) is the Community Developmental Disabilities Organization (CDDO) for
Long Term Care Medicaid. Long Term Care (LTC) Medicaid
Long Term Care Medicaid Part 5 Long Term Care (LTC) Medicaid Long Term Care Medicaid includes: Home and Community Based Waivers Medicaid Family Care IRIS Partnership PACE Institutional Medicaid 1 Home
Council 5 Year Plan (2017 2021) Draft Overview. Patrick Reinhart
Council 5 Year Plan (2017 2021) Draft Overview Patrick Reinhart GOAL 1 People with disabilities have the knowledge and skills to advocate on an individual and systemic level. Objective 1.1 The Council,
NJPRA Annual Conference 11/21/14. Lynn A. Kovich Assistant Commissioner
NJPRA Annual Conference 11/21/14 Lynn A. Kovich Assistant Commissioner Agenda DMHAS Office Reorganization MLTSS Overview Housing and Services Community Support Services Mental Health System Trends 2 Reorganization
Care Coordination Perspectives: Past and Future
Care Coordination Perspectives: Past and Future Best Practices Care Coordination Conference November 17, 2014 Pam.parker@state.mn.us History of MSHO/MSC+ A Bright Idea: Medicare and Medicaid should coordinate!
July 27 th, 2015. Dear Acting Director Slavitt,
July 27 th, 2015 Centers for Medicare & Medicaid Services Department of Health and Human Services Attn: CMS- 2390- P P.O. Box 8016 Baltimore, MD 21244-8016 Re: Proposed Rule for Medicaid and Children s
Appendix 4: SPA and Waiver Options to Enhance Concurrent Care Programs
Appendix 4: SPA and Waiver Options to Enhance Concurrent Care Programs Medicaid State Plan Options Each state describes its Medicaid program in the Medicaid State Plan. The State Plan specifies how the
Most Frequently Asked Questions about Applied Behavior Analysis Services for the Treatment of Children under 21 with Autism Spectrum Disorders
Most Frequently Asked Questions about Applied Behavior Analysis Services for the Treatment of Children under 21 with Autism Spectrum Disorders Common Abbreviations ABA Applied Behavior Analysis AHCA The
Balancing Incentive Program Application
Balancing Incentive Program Application 02/08/2013 Contents PROJECT ABSTRACT AND PROFILE... 3 PRELIMINARY WORK PLAN... 3 LETTERS OF ENDORSEMENT... 5 APPLICATION NARRATIVE... 6 Understanding of Balancing
Wisconsin Money Follows the Person Sustainability Plan April 2015
1. Executive Summary Wisconsin Money Follows the Person Sustainability Plan April 2015 For more than 30 years, Wisconsin has supported and promoted home and community-based services through a variety of
North Carolina Department of Health and Human Services Division of Medical Assistance March 15, 2013
North Carolina Department of Health and Human Services Division of Medical Assistance March 15, 2013 RFI-DMA100-13 Request for Information: Improving Efficiency and Effectiveness of the State s Medicaid
How To Get A Health Care Benefit In Texas
RULE 354.1448 Purpose (a) This chapter governs provisions related to the Community First Choice (CFC) benefit. (b) CFC establishes a new state plan option to provide certain home and community based supports.
STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE Suzanne Murrin Deputy Inspector General for Evaluation and Inspections September
The Concept Paper outlines the following features of the proposed new model, Family Care/IRIS 2.0.
1 Table of Contents Executive Summary... 3 Introduction... 6 Public and Stakeholder Engagement... 6 Guiding Principles... 7 Program Design... 8 Member Self-Direction of Long-Term Care Services... 8 Family
Charting the System for Persons with Autism Spectrum Disorder. Page 1
EI Early Intervention Families with eligible children receive an Individualized Family Service Plan (IFSP), which lists the s and supports that are needed for the child to achieve his/her outcomes. Services
Presented to: Long Term Care Workgroup May 26, 2011
Presented to: Long Term Care Workgroup May 26, 2011 Partners in the Grant SC Department of Health and Human Services Sam Waldrep Roy Smith Project Coordinator Office of Research and Statistics Institute
Medicaid Home- and Community-Based Waiver Programs
INFORMATION BRIEF Research Department Minnesota House of Representatives 600 State Office Building St. Paul, MN 55155 Danyell Punelli, Legislative Analyst 651-296-5058 Updated: November 2013 Medicaid Home-
(as per GRS1.1 Correspondence and Memoranda under Executive, High- Level and Policy-Making Records section.)
HHS Executive Office of Health and Human Services The Executive Office of Health and Human Services (EOHHS) was created in 2006 (Public Law 2006, Ch. 246, Art. 38, Section 19 and RIGL 42-7.2 et. seq.).
COMPARISON BETWEEN IOWA HIGH QUALITY HEALTH CARE INITIATIVE SCOPE OF WORK AND NATIONAL COUNCIL ON DISABILITY GUIDING PRINCIPLES
COMPARISON BETWEEN IOWA HIGH QUALITY HEALTH CARE INITIATIVE SCOPE OF WORK AND NATIONAL COUNCIL ON DISABILITY GUIDING PRINCIPLES MARCH 6, 2015 (REV. MARCH 31, 2015) 1 INTRODUCTION The Iowa Department of
The Louisiana Behavioral Health Partnership
The Louisiana Behavioral Health Partnership Transforming the lives of our youth Supporting adults in need Keeping families together Kathy Kliebert Deputy Secretary What is the Louisiana Behavioral Health
Managed Care Solutions for Long-Term Services and Supports A Sustainable Future
Managed Care Solutions for Long-Term Services and Supports A Sustainable Future March 2014 Executive Summary Implementing a Medicaid Managed Long-term Services and Supports (MLTSS) program represents a
New Jersey Balancing Incentive Program. Application for the State of New Jersey
New Jersey Balancing Incentive Program Application for the State of New Jersey New Jersey Department of Human Services December 2012 State of New Jersey Balancing Incentive Program Table of Contents Cover
Update on Managed Long Term Services and Supports (MLTSS): DHS Services and the NJ Comprehensive Medicaid Waiver
Update on Managed Long Term Services and Supports (MLTSS): DHS Services and the NJ Comprehensive Medicaid Waiver New Jersey Foundation for Aging June 11, 2014 Nancy Day, Deputy Director, Division of Aging
Overview of Managed Long Term Services and Supports
Overview of Managed Long Term Services and Supports 1 Presentation Topics 2 Background of Managed Long Term Services implementation in New Jersey Member Eligibility for MLTSS Overview Program for All-Inclusive
Managed Care in New York
Managed Care in New York This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program
King County Developmental Disabilities Division
King County Developmental Disabilities Division Older Adults with Intellectual and Developmental Disabilities Presentation for Aging & Disability Service Advisory Council Holly Woo April 10, 2015 Role
EQR PROTOCOLS INTRODUCTION
OMB Approval No. 0938-0786 EQR PROTOCOLS INTRODUCTION An Introduction to the External Quality Review (EQR) Protocols Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services
Vermont has been one of the nation s leaders in ensuring
Health Reform: New Opportunities For Vermont To Invest in Home- and Community-Based Services Vermont has been one of the nation s leaders in ensuring that seniors and people with disabilities are able
Minnesota s Dual Demonstration: Managed care model to promote integration of Medicare and Medicaid
Minnesota s Dual Demonstration: Managed care model to promote integration of Medicare and Medicaid Lauren Siegel Dual Demonstration Project Coordinator Minnesota Department of Human Services National Home
4. Program Regulations
Table of Contents iv 437.401: Introduction... 4-1 437.402: Definitions... 4-1 437.403: Eligible Members... 4-2 437.404: Provider Eligibility... 4-3 437.405: Out-of-State Hospice Services... 4-3 437.406:
States Uses of Enhanced FMAP
States Uses of Enhanced FMAP Permissible Uses of Enhanced FMAP... 2 Summary of States Uses of Enhanced FMAP... 3 Arkansas... 6 Connecticut... 7 Georgia... 8 Illinois... 9 *Indiana... 10 Iowa... 11 Kentucky...
MAD-MR: 12-01 CASE MANAGEMENT SERVICES Eff: 3-1-12 CASE MANAGEMENT SERVICES FOR CHILDREN UP TO AGE THREE INDEX
INDEX 8.326.6 8.326.6.1 ISSUING AGENCY...1 8.326.6.2 SCOPE...1 8.326.6.3 STATUTORY AUTHORITY...1 8.326.6.4 DURATION...1 8.326.6.5 EFFECTIVE DATE...1 8.326.6.6 OBJECTIVE...1 8.326.6.7 DEFINITIONS...1 8.326.6.8
Maryland Medicaid s Partnership in Improving Behavioral Health Services. Susan Tucker Executive Director, Office of Health Services May 14, 2014
Maryland Medicaid s Partnership in Improving Behavioral Health Services Susan Tucker Executive Director, Office of Health Services May 14, 2014 Began in 1966 Maryland Medicaid By FY 14, we provided full
Re: Managed Long Term Services and Supports [MLTSS] Discussion Document
![Re: Managed Long Term Services and Supports [MLTSS] Discussion Document](/thumbs/20/1008091.jpg "Re: Managed Long Term Services and Supports [MLTSS] Discussion Document")
July 15, 2015 Theodore Dallas, Secretary Department of Human Services Harrisburg PA 17120 Teresa Osborne, Secretary Department of Aging Harrisburg PA 17120 Re: Managed Long Term Services and Supports [MLTSS]
Presentation to State Medicaid Managed Care Advisory Committee: Network Adequacy. March 2014
Presentation to State Medicaid Managed Care Advisory Committee: Network Adequacy March 2014 Network Access: Federal & State Laws & Regulations In Medicaid, MCOs must: Have sufficient capacity to serve
State Demonstrations to Integrate Care for Dual Eligibles. Demonstration Proposal. Vermont
State Demonstrations to Integrate Care for Dual Eligibles Demonstration Proposal Vermont Summary: In 2011, Vermont was competitively selected to receive funding through CMS State Demonstrations to Integrate
RESPONSES TO QUESTIONS ABOUT ROLE DEFINITIONS FOR TARGETED CASE MANAGERS (TCM) AND CARE COORDINATORS (CC)
RESPONSES TO QUESTIONS ABOUT ROLE DEFINITIONS FOR TARGETED CASE MANAGERS (TCM) AND CARE COORDINATORS (CC) We are still fine-tuning the implementation of KanCare for consumers with intellectual/developmental
Maryland Alphabet Soup BIP, MFP, ADRCs, MAP and TBI. Stefani O Dea Maryland Mental Hygiene Administration/ TBI Lead Agency
Maryland Alphabet Soup BIP, MFP, ADRCs, MAP and TBI Stefani O Dea Maryland Mental Hygiene Administration/ TBI Lead Agency Maryland LTSS Landscape Like many other states, Maryland has decided to implement
2012 EXTERNAL QUALITY REVIEW (EQR) PROTOCOLS
2012 EXTERNAL QUALITY REVIEW (EQR) PROTOCOLS APPENDIX V: INFORMATION SYSTEM CAPABILITIES ASSESSMENT ACTIVITY REQUIRED FOR MULTIPLE PROTOCOLS TABLE OF CONTENTS PURPOSE AND OVERVIEW OF THE APPENDIX... 1
Balancing Incentive Program s Proposed No Wrong Door Structure
Redesign Medicaid in New York State Balancing Incentive Program s Proposed No Wrong Door Structure Mark Kissinger, Director Division of Long Term Care, Office of Health Insurance Programs, NYSDOH June
ADRC READINESS CHECKLIST
ADRC READINESS CHECKLIST This checklist is intended to help in planning for the development of and evaluating readiness to begin operations as an Aging and Disability Resource Center (ADRC). The readiness
Managed Care in Minnesota
Managed Care in Minnesota This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program
Medicaid Long Term Services and Supports: A Review of Available Evidence
Medicaid Long Term Services and Supports: A Review of Available Evidence Table of Contents Introduction 2 Key Findings 2 Section 1: Overview of MLTSS 3 Section 2: Implementation Experiences 7 Section 3:
Maryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland As of July 2003, 638,662 people were covered under Maryland's Medicaid/SCHIP programs. There were 525,080 enrolled in the Medicaid
Memorandum of Understanding (MOU) The Centers for Medicare & Medicaid Services (CMS) The State of Colorado
Memorandum of Understanding (MOU) Between The Centers for Medicare & Medicaid Services (CMS) And The State of Colorado Regarding a Federal-State Partnership to Test a Managed Fee-for-Service (MFFS) Financial
Managed Care in Florida
in Florida This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program start date may
WISCONSIN LONG-TERM CARE COMPARISON CHART FOR ADULTS WITH DISABILITIES
WISCONSIN LONG-TERM CARE COMPARISON CHART FOR ADULTS WITH DISABILITIES This document provides an overview of the Medicaid long-term programs available for adults with disabilities and frail elders in Wisconsin.
Kansas Department for Aging & Disability Services Request for Information (RFI)
Kansas Department for Aging & Disability Services Request for Information (RFI) Aging & Disability Resource Center (ADRC) Ensuring a No Wrong Door (NWD), Single Entry Point (SEP) System for Aging and Disabled
EQR PROTOCOL 1: ASSESSMENT OF COMPLIANCE WITH MEDICAID MANAGED CARE REGULATIONS
OMB Approval No. 0938-0786 EQR PROTOCOL 1: ASSESSMENT OF COMPLIANCE WITH MEDICAID MANAGED CARE REGULATIONS A Mandatory Protocol for External Quality Review (EQR) Protocol 1: Protocol 2: Validation of Measures
Innovative State Practices for Improving The Provision of Medicaid Dental Services:
Innovative State Practices for Improving The Provision of Medicaid Dental Services: SUMMARY OF EIGHT STATE REPORTS: (Alabama, Arizona, Maryland, Nebraska, North Carolina, Rhode Island, Texas and Virginia)
Chapter 14 HIGHLIGHTS INTELLECTUAL & DEVELOPMENTAL DISABILITIES INTRODUCTION
INTELLECTUAL & DEVELOPMENTAL DISABILITIES Chapter 14 HIGHLIGHTS INTRODUCTION Become the first accredited state intellectual and developmental disabilities service delivery system in the nation. When accomplished,
Managed Care in Illinois
Managed Care in Illinois This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program
Executive Summary. ISSUES FROM THE STATES Advocating for Improved Consumer Protections in Managed Long-Term Services and Supports.
ISSUES FROM THE STATES Advocating for Improved Consumer Protections in Managed Long-Term Services and Supports ISSUE BRIEF APRIL 2015 Written By Eric Carlson Directing Attorney, Justice in Aging Executive
Physical Therapist (Individual)
PROVIDER TYPE SPECIFIC PACKET/CHECKLIST (Louisiana Medicaid) Physical Therapist (Individual) (Enrollment packet is subject to change without notice) GENERAL INFORMATION FOR PROVIDER ENROLLMENT Provider
Alabama Autism Task Force Preliminary Recommendations
Alabama Autism Task Force Preliminary Recommendations Having reviewed the findings to date from the Alabama Autism Collaborative Group (AACG), The Alabama Autism Task Force proposes the following changes
Balancing Incentive Program Application 6/29/2012
Balancing Incentive Program Application 6/29/2012 Table of Contents Project Abstract and Profile... 6 Texas Balancing Incentive Program Preliminary Work Plan... 7 Letters of Endorsement... 12 Section A.
Quality Assurance Plan for Home and Community-Based Services
Quality Assurance Plan for Home and Community-Based Services Summary Report of Plans Forwarded by Counties and Tribes For 2008 Department of Human Services Continuing Care Administration July 2008 Final
ADDENDUM to. Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid
ADDENDUM to Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid Proposal to the Center for Medicare and Medicaid Innovation State Demonstration to Integrate Care
Quality Strategy for the New York State Medicaid Managed Care Program 2014
Quality Strategy for the New York State Medicaid Managed Care Program 2014 Prepared by The New York State Department of Health Office of Quality and Patient Safety Bureau of Performance Improvement and
Florida Medicaid. Managed Care Quality Assessment & Improvement Strategies. 2008/2009 Update
Florida Medicaid Managed Care Quality Assessment & Improvement Strategies 2008/2009 Update Agency for Health Care Administration Florida Medicaid s quality assessment and improvement strategies reflect
MANAGED CARE OPTIONS FOR MEDICAID LONG-TERM SERVICES AND SUPPORTS
MANAGED CARE OPTIONS FOR MEDICAID LONG-TERM SERVICES AND SUPPORTS An Unsustainable Course Medicaid costs continue to climb nationwide, taking up an increasing percentage of state budgets. These expenditures
Disabled & Elderly Health Programs Group. October 15, 2015
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-14-26 Baltimore, Maryland 21244-1850 Disabled & Elderly Health Programs Group October