Long Term Care Medicaid Waiver

MEDICAID: Financial Characteristics of Approved Applicants and Methods Used to Reduce Assets to Qualify for Nursing Home Coverage

What GAO Found GAO’s review of 294 approved Medicaid nursing home applications in three states showed that 41 percent of applicants had total resources—both countable and not countable as part of financial eligibility determination—of $2,500 or less and 14 percent had over $100,000 in total resources. Distribution of Approved Applicants in Selected Counties in Three […]

Continuity of Care Requirements in the Managed Medical Assistance Program

The Statewide Medicaid Managed Care (SMMC) program consists of two components: the Managed Medical Assistance (MMA) program and the Long-term Care (LTC) program. The MMA program provides medical services to infants, children and adults on Medicaid, while the LTC program provides home and community-based long-term care services to elders and adults with disabilities on Medicaid […]

SMMC Enrollment Decision Tree For The Elderly

Are you an elder faced with enrollment decisions? This decision tree is here to help you understand the decisions you will need to make, as well as understand how to protect your rights. Find out more according to where you land using this color coded resource from LTC Foundation Solutions.

Consumer Guide on Enrollment Choice for the New Medicaid Managed Care Program

Click to Download the FREE Consumer Guide on Enrollment Choices for the New Medicaid Managed Care Program. This is an easy to understand guide for senior citizens (and their decision-makers). It breaks down new MMC program for long term services. Visit www.LTCFoundation.org to learn more about this program and other changes to Medicaid Managed Care.

Pitfalls Seen in a Turn to Privately Run Long-Term Care

By Nina Bernstein, New York Times NASHVILLE — Even as public attention is focused on the Affordable Care Act, another health care overhaul is underway in many states: an ambitious effort to restrain the ballooning Medicaid cost of long-term care as people live longer and survive more disabling conditions. At least 26 states, including California, Florida, Illinois andNew York, are rolling […]

Having Problems With New SMMC Program? Here’s How to Complain

You may encounter circumstances, such as your choices or the care you receive, where something is just not right. In these cases, you may have a complaint. Discussed in this section are a FEW of the areas where you may have a concern arise. It is possible you will not see a question or answer […]

How to Apply the External Quality Review Protocols

CMS released guidance to states on October 22, 2013 on how to apply the External Quality Review protocols developed in 2012 by CMS.  Federal law requires state Medicaid agencies to develop a state quality assessment and improvement strategy for their Managed care contracts for long term care. Click for more information.

States Balk At Terminating Medicaid Contracts Even When There’s Fraud Or Poor Patient Care

This Kaiser Health News story was produced in collaboration with The Washington Post. In Florida, a national managed care company’s former top executives were convicted in a scheme to rip off Medicaid. In Illinois, a state official concluded two Medicaid plans were providing “abysmal” care. In Ohio, a nonprofit paid millions to settle civil fraud […]

Letter: Issues & Concerns with State’s Medicaid Managed Care LTC Waiver

Click for a letter to CMS from Long Term Care advocates in the state of Florida, addressing some of the concerns regarding Florida’s Statewide Medicaid Managed are Long Term Care Waiver.

Notice of Department of Elder Affairs Meeting: August 29, 2013

The Department of Elder Affairs will be holding a Meeting/Workshop Hearing conference call on the Medicaid Managed Care Long Term Care transition and the Florida Ombudsman program: Date & Time: Thursday, August 29, 2013, 2 p.m. (EDT) Conference Call Number: 1(888) 670-3525, Conference Code: 962-076-0613 Click to learn more.