As your health plan becomes engaged with persons eligible for both Medicare and Medicaid – particularly those with behavioral health needs, developmental disabilities, or substance abuse challenges – you may find it necessary to provide behavioral health long-term services and
[...]More states are contracting with health plans to manage Medicaid long-term services and supports (LTSS). As a result, you may find yourself working with health plans instead of the state to provide care for your Medicaid clients. Contracting with a
[...]Many states are implementing managed long-term services and supports (LTSS) to better coordinate care for Medicaid recipients. This may change the way your organization provides Medicaid services by requiring you to contract or enter into an agreement with one or
[...]As more states expand managed long-term services and supports (LTSS) options, there will be new opportunities to integrate acute and long-term care. This will require plans, which may already have considerable experience contracting with acute care providers, to negotiate agreements
[...]Adequate oversight of the delivery of personal care services in participant-directed programs is vital so that members’ individual service plans are carried out correctly and prevent fraud and abuse. However, monitoring the provision of services in participant-directed programs can be
[...]Health plans increasingly will be required to manage, monitor, and oversee a broader range of services as more states contract for managed long-term services and supports (LTSS). Oversight includes preventing fraud and abuse, which requires ensuring that the services billed
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