Pennsylvania Invites Comment as Part of Medicaid Managed Long-Term Services and Supports Planning Process
This article was originally published on PR Newswire by Kait Gillis on June 1st, 2015.
The Departments of Human Services (DHS) and Aging (PDA) today released a discussion document that is the next critical step in Governor Wolf's plan to improve care coordination and to move to a Medicaid Managed Long-Term Services and Supports (MLTSS) program.
This document lays out how the Governor's proposed FY 2015-16 budget commitment to better the lives of older Pennsylvanians and individuals with physical disabilities will occur, by streamlining eligibility for and access to services while enhancing their quality and coordination.
In February 2015, the Governor directed the departments to explore MLTSS as a way to increase opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. When giving this charge, the Governor encouraged innovation, making it clear that the status quo is not acceptable.
"Over 95% of Pennsylvanians want to age in their home and not in an institution. The Governor's plan will provide more choices for those who want to live in the community," said Acting DHS Secretary Ted Dallas. "The results will be better access to health care, more choices, and better results."
This initiative will result in a more strategic care delivery system and improve health outcomes for seniors and individuals with disabilities. By contracting with Managed Care Organizations, MLTSS will create a capitated model that will improve care coordination and health outcomes while allowing more individuals to live in their community.
Dual eligible adults (excluding individuals eligible for Medicaid-funded and Base-funded programs available through the Office of Developmental Programs) over the age of 21 who are entitled to Medicare Part A and/or Part B and Part D and are eligible for Medicaid benefits, all nursing facility clinically eligible (NFCE) non-dual eligible adults age 18 and older who are eligible for the Pennsylvania Medicaid Program, and Non-Medicaid recipients of the Act 150 Program will be enrolled in MLTSS.
DHS and PDA will engage stakeholders to ensure that the system is person-centered, breaks down barriers, and fills in the gaps that exist in the long-term care services and supports system. Pennsylvania currently serves more than 130,000 Pennsylvania adults with LTSS needs in the Medicaid program.