MLTSS Steering Committee Report, February 21
On February 21, the MLTSS Steering Committee had its regularly scheduled quarterly meeting with the Division of Aging Services and the Division of Medical Assistance and Health Services. Click here to download MLTSS Steering Committee Presentation and Bipartisan Budget Act of 2018.
Below is a summary of the key discussion points:
- DMAHS presented a summary of the many changes to the Medicaid MCO contract that took effect as of July 2017 and were largely the result of the federal Medicaid managed care final rule. With respect to MLTSS, the changes of note are: extension of AWP through June 2018; addition of any willing qualified provider; addition of more robust readiness review procedures when an MCO makes a material change in a process that affects consumers and/or providers; requirement for each MCO to have a housing specialist; revisions to the MLTSS performance measures resulting in greater specificity; addition of language requiring MCOS to pay hospice room and board for patients in nursing homes at 95% of the Medicaid rate. The full contract with all changes can be found at http://www.state.nj.us/humanservices/dmahs/info/resources/care/hmo-contract.pdf The MLTSS section is Article 9.
- Center for Healthcare Strategies presented information on the Bipartisan Budget Act of 2018 – see attached handout.
- The Division of Aging Services presented updates on MLTSS utilization and enrollment – see attached slides
- The Office of Business Intelligence presented on the data dashboards that will be released in the summer. Details of the initial phase of the data dashboards can be reviewed here http://www.state.nj.us/humanservices/dmahs/boards/maac/MAAC_Meeting_Presentations_1_24_18.pdf MCO data related to prompt payment, appeals and denials will be part of phase two of the dashboards.
- The Division of Aging Services updated the Steering Committee on any willing qualified provider implementation. Updates and details are available at http://www.nj.gov/humanservices/dmahs/home/mltss_nhq.html, including the Feb. 2018 data release for all nursing homes.
- The Steering Committee is going to initiate a few works groups to address process, policy and procedure. Suggestions are being gathered, but the initial ideas are to have a steering committee work group on communication of critical incidents and changes in resident status between MCOs and providers, network capacity for respite services and guardianship issues related to MLTSS beneficiaries.
Please feel free to contact Jim McCracken or Theresa Edelstein with any questions or concerns about the MLTSS Steering Committee, and please remember to join us on March 6 for our Medicaid managed care seminar. Registration is still open at http://www.njha.com/education/brochure/?id=1864
