Important Medicaid Updates

Recently the Centers for Medicare & Medicaid Services (CMS) has posted two important documents on Medicaid.gov that outline essential elements that we believe are critical to strong managed long term services and supports (MLTSS) programs. The first of the two documents includes a summary overview of each element. The second document outlines, in detail, each element and the expectations associated with each.

The critical elements and program expectations were developed based principally on review of successful, established state programs, and supplemented with knowledge obtained during review and negotiation regarding recent state proposals, input from a number of advocacy and other stakeholder groups, as well as dialogue with state and national experts and federal partners. We believe these essential elements represent a framework for achieving our shared vision of assuring that MLTSS programs are an effective approach to increased access to home and community based services, improved outcomes for individuals who live with chronic and disabling conditions, and appropriate cost control within these critical programs.

Resources
Summary of Managed Long Term Services and Supports Programs Essential Elements
Guidance to States using 1115 demonstrations or 1915(b) waivers for Managed Long Term Services and Supports Programs

CMS expects states to incorporate these principles into any MLTSS program operating under section 1115 demonstration authority or 1915(b) waiver authority applied in combination with another LTSS authority. CMS will use these principles when reviewing states’ design, implementation, and operation of an MLTSS program before approving that program, and on an ongoing basis to ensure.