A growing number of states are proposing to place the responsibility for providing long-term services and supports (LTSS) to seniors and people with disabilities under managed care organizations (MCOs). These proposals offer both significant risk, and considerable opportunity. Strong beneficiary protections specific to the delivery of LTSS must be incorporated to ensure that states and MCOs develop models that best supports independence and the ability of beneficiaries to remain in or return to community settings.

Advocates’ Guide to Accessibility in Medicaid Managed Care Grievances and Appeals

Accessible PDF:  https://dredf.org/wp-content/uploads/2018/07/Advocates-Guide-to-Accessibility-in-Medicaid-Managed-Care-Appeals.pdf

Accessible Word:  https://dredf.org/wp-content/uploads/2018/06/Advocates-Guide-to-Accessibility-in-Medicaid-Managed-Care-Appeals-6-29-2018.docx

html version:  https://dredf.org/healthcare-access/advocates-guide-to-accessibility-in-medicaid-managed-care-grievances-and-appeals/

In May 2016, the federal government published extensive new Medicaid managed care regulations that will affect every aspect of coverage provided through managed care. Justice in Aging developed a searchable tool to assist advocates in using and analyzing the new regulations. Access the tool.

Medicaid Managed Care Rules: Key Considerations for Aging Advocates. Read the brief.

What’s in a Notice? How Notices of Action Protect Consumers in Medicaid Managed Long Term Services and Support. Read the brief.

Can Reality Match Rhetoric: Person-Centered Service Planning in Managed Long-Term Services and Supports provides an overview of service planning in the Medicaid managed care context and an analysis of what states are doing.

Advocate Recommendations for Measuring Rebalancing in Dual Eligible Demonstrations (January 2014). Read the Letter

Summary of CMS Guidance on Managed Long-Term Services and Supports (May 2013).