On April 29 the Department of Medical Assistance Services (DMAS) issued its request for proposals (RFP) for the Medicaid Managed Long Term Services and Supports (MLTSS) program.  MLTSS will create a new, mandatory Medicaid-only managed care product for individuals in the entire state. You can read the RFP here.

MLTSS will build upon the dual-eligible Commonwealth Coordinated Care (CCC) demonstration program, which is scheduled to phase out at the end of 2017.  DMAS expects to roll-out the mandatory MLTSS program by region beginning in the summer of 2017.  The implementation for the CCC-eligible population (including opt-outs) will transition on a longer timeline into 2018.

DMAS anticipates that it will enter into contracts with no fewer than two health plans per region. DMAS has said it will consider contracting with specialty plans as an effort to test  innovative, person-centered models of care that align with MLTSS goals for transforming service delivery.

According to information VHCA has learned from DMAS, nursing centers should expect to be approached by health plans in the coming weeks as the plans work to develop their preliminary networks.  Plans may ask providers to sign letters of intent (LOI). VHCA has asked the agency to ensure that nursing centers have adequate time to evaluate these LOIs without the pressure of an immediate deadline from the health plans to set their networks.

VHCA is currently reviewing the RFP to assess its impact on nursing center services.  VHCA provided a significant number of comments on elements that should and should not be included in the RFP based on nursing centers’ experience with the CCC program.  Two of VHCA’s committees will discuss the RFP in meetings later this month.  If you have any comments or questions about the RFP, please contact Steve Ford.