Situation Report | July 13, 2020
The state Department of Health (DOH) has released guidance related to a two-year moratorium on the processing and approval of applications for the operation of Managed Long Term Care (MLTC) plans.
This moratorium stems from a change in the state budget. It became effective on April 1, 2020 and will continue until March 31, 2022.
The moratorium applies to the processing and approval of MLTC applications that: 1) seek a new certificate of authority to operate an MLTC plan; 2) expand the service area of an existing MLTC plan; and 3) expand the scope of eligible MLTC plan enrollees.
The law has some limited exceptions for the processing and approval of applications including those:
- Submitted to DOH and not withdrawn prior to January 1, 2020.
- Seeking to transfer or acquire ownership or control of an existing MLTC plan.
- That address, to DOH’s satisfaction, a “serious concern” with care delivery, as more fully specified in the guidance.
- For the Program of All-Inclusive Care for the Elderly (PACE) model, Medicaid Advantage Plus or Medicaid Advantage.
Questions may be directed to firstname.lastname@example.org.
HCA opposed this moratorium and other negative MLTC actions when proposed by the Medicaid Redesign Team (MRT) during the budget process. HCA is engaged with fellow associations and MLTC members to mitigate and try to reshape as best as possible the state’s MLTC-adverse initiatives that were adopted in this year’s budget and that are now moving to implementation phase.