Situation Report | June 21, 2021
Last week, the state Department of Health (DOH) met with HCA and other associations representing Managed Long Term Care (MLTC) plans and services to discuss the startup of Uniform Assessment System (UAS) reassessments for MLTC patients. The reassessments have been suspended during the COVID-19 pandemic.
DOH was interested in our feedback on: the appropriate lead-time for plans to initiate in-person reassessments of their members; how they would prioritize which members to reassess first; how long it would take to reassess all of their members; and whether the plans favor the continued ability to conduct assessments via telehealth and/or telephone, and under what situations.
Also discussed was the expected impact of the state initiating its Independent Assessor (IA) program. HCA is concerned about the effect that this new program — and, specifically, the IA’s employment of already scarce nursing resources — would have on MLTC and network providers’ nursing staff and MLTC operations in general.
HCA and our colleague associations offered some preliminary comments on all of the above issues. We emphasized the need for lead-time and flexibility so that plans could effectively prepare for the transition back to in-person assessments. We also voiced concern about the impact of new and expanded assessment activity by the IA at some later date, and whether these activities would worsen existing MLTC/provider workforce shortages in many areas of the state.
HCA immediately followed up with a survey of MLTC plans in the HCA membership for input.
DOH said that it does not expect the IA to begin assessments until sometime this fall and that this process is part of a regulatory package that includes other items (changes to eligibility criteria for MLTC services, allowing nurse practitioners and physician assistants to sign orders for home care, and others) that is being reviewed by the U.S. Centers for Medicare and Medicaid Services.
HCA will be following up with DOH to further convey member input.
HCA has major concerns with the entire IA concept, which we believe is an added and costly layer to the long term care system, and contradictory to the goals of integrated care and coordinated clinical practice.