Our Issues

In collaboration with Medicaid Health Plans of America (MHPA), the MLTSS Association is excited to release a new brief highlighting the essential role of Medicaid managed care plans in combatting fraud, waste, and abuse (FWA) and preserving access to high quality, person-centered care in HCBS delivery. In partnership with states and the federal government, Medicaid MCOs take a comprehensive approach to ensuring that HCBS are delivered appropriately, to the right people, in th

In May, the MLTSS Association sent a letter to officials at CMS outlining key themes and recommendations to improve the MLTSS rate setting process. Actuarially sound rates are a critical component of Medicaid managed care to ensure that Managed Care Organizations (MCOs) receive adequate funding to serve their members. This is especially crucial for Managed Long-Term Services and Supports (MLTSS) plans that manage services for individuals with often long-term and chronic condi

In June, the MLTSS Association sent a letter to CMS outlining recommendations to support program integrity in Medicaid Home and Community-Based Services (HCBS). MLTSS plans invest substantially in fraud, waste, and abuse (FWA) detection and prevention through both upstream controls and layered detection models, including credentialing and provider enrollment validation, person-centered planning processes, and authorization guardrails, which work to prevent FWA before it occur

On May 28th, the MLTSS Association submitted comments on the 2028 Proposed HCBS Measure Set. In our comments, we expressed our appreciation for CMS’s continued efforts to promote greater consistency and comparability in HCBS quality measurement across states. Standardized, nationally comparable quality data is essential to understanding whether HCBS programs are effectively meeting the needs of members and ensuring responsible use of taxpayer funds. The Association also suppo

In 2025, the MLTSS Association published our Policy Proposals to Advance Integrated Care, which included our proposal on auto-enrollment. This proposal outlines two complementary pathways that can be utilized to promote enrollment of dually eligible individuals into integrated D-SNPs, ultimately increasing access to coordinated and person-centered care. These new accompanying resources provide additional rationale to support this proposal. Our brief Expanding Auto-Enrollment

Today approximately 10 percent of individuals who are dually eligible for both Medicare and Medicaid are enrolled in managed care plans that fully integrate their Medicare and Medicaid coverage. The remaining dually eligible individuals must navigate a complex system of overlapping coverage and disconnected services. Despite significant regulatory and legislative activity around advancing integrated care models at both the state and federal level, many barriers remain. The Na

The Pennsylvania Value-Based Purchasing Innovation Showcase is an exciting opportunity for providers that serve participants in Pennsylvania's Community HealthChoices Program. This special forum will offer providers a unique opportunity to pitch their most innovative ideas for Value-Based Purchasing (VBP) Models. The National MLTSS Health Plan Association is pleased to host this opportunity in collaboration with the Community HealthChoices (CHC) Managed Care Organization (MCO

The MLTSS Association responded to the CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH). In our response, we highlight how managed care offers solutions for effective oversight and delivery of HCBS, and how managed LTSS programs support broader Medicaid program integrity efforts while providing essential services to millions of Americans.

Are you a graduate student interested in learning more about Medicare, Medicaid, or long-term services and supports (LTSS)? Our Atkins Fellowship offers an exciting opportunity to delve into LTSS policy through research, policy analysis, and engagement with diverse stakeholders. Applications are now open for full-time summer fellowships. We are flexible on start and end dates and will work with successful candidates to create a fellowship schedule that works for them. Fello

On December 31st, 2025, the MLTSS Association responded to a Request for Information (RFI) from the Idaho Department of Health and Welfare (IDHW). This RFI sought input from members, providers, managed care organizations, and pharmacy benefit managers regarding what they would like to see in a comprehensive managed care plan.

On Thursday, March 12th, the MLTSS Association held a national webinar to about our recent report, Unlocking the Value of Enabling Technology in Managed LTSS . On this webinar, the MLTSS Association was joined by select health plan and Partnership Program members who shared promising practices to advance enabling technology from their organizations.

The MLTSS Association's recent report, Unlocking the Value of Enabling Technology in Managed LTSS , explores the policy, operational, and payment challenges that limit adoption of Enabling Technologies and recommendations to overcome them. This report is structured around 5 Key Domains: Evaluating New and Existing Technologies; Streamlining Funding Pathways; Facilitating Member, Caregiver, and Provider Education; Ensuring Member Safety and Empowerment; and Measuring the Impac

The MLTSS Association's recent report, Unlocking the Value of Enabling Technology in Managed LTSS , explores the policy, operational, and payment challenges that limit adoption of Enabling Technologies and recommendations to overcome them. This report is structured around 5 Key Domains: Evaluating New and Existing Technologies; Streamlining Funding Pathways; Facilitating Member, Caregiver, and Provider Education; Ensuring Member Safety and Empowerment; and Measuring the Impac

The MLTSS Association's recent report, Unlocking the Value of Enabling Technology in Managed LTSS , explores the policy, operational, and payment challenges that limit adoption of Enabling Technologies and recommendations to overcome them. This report is structured around 5 Key Domains: Evaluating New and Existing Technologies; Streamlining Funding Pathways; Facilitating Member, Caregiver, and Provider Education; Ensuring Member Safety and Empowerment; and Measuring the Impac

The MLTSS Association signed on to a letter submitted by the Medicare-Medicaid Integration Alliance (MMIA) on January 22 nd . This letter, sent to Daniel Brillman, Deputy Administrator of CMS and the Director of CMCS, outlined the Alliance’s position on the Implementation of HR 1 and opportunities to enhance protections for dually eligible individuals. Specifically, this letter included recommendations for CMS on how to ensure that dually eligible individuals and caregivers,

On January 29th, the MLTSS Association submitted comments to the Nebraska Legislature in response to LB832: A bill to extend the prohibition of the addition of long-term care services and supports to the Medicaid managed care program. In our comments, we emphasize the value of managed long-term services and supports (MLTSS) and how managed care can support states to deliver critical services in a way that ensures high-quality care, improves coordination, and uses resources mo

On January 25, 2026, the MLTSS Association submitted comments on the Contract Year 2027 Medicare Advantage and Part D Proposed rule. Many of the changes contemplated for CY 2027 in this proposed rule represent meaningful shifts in enrollment policy, contracting requirements, quality measurement, and plan operations. To be successful, these changes must be implemented on timelines that allow health plans and states sufficient opportunity to understand final requirements, make

The National MLTSS Health Plan Association is pleased to announce the release of a new resource , Unlocking the Value of Enabling Technology in Managed LTSS . This report examines how enabling and assistive technologies can support independence, strengthen community-based care, and improve quality of life for individuals receiving long-term services and support while also helping states, plans, and providers respond to workforce shortages, rising demand, and fiscal constrain

The MLTSS Association has created a resource highlighting an operational issue in state Medicaid policy affecting some Dual Eligible Special Needs Plans (D-SNPs) that are Applicable Integrated Plans (AIPs), where timing gaps in enrollment can delay alignment with an individual's Medicaid plan. These gaps may cause temporary coverage misalignment, member confusion, and risk plans’ compliance with CMS AIP requirements. In this resource, we outline the implications of this issue

The MLTSS Association has written a letter to CMS highlighting an operational issue in state Medicaid policy affecting some Dual Eligible Special Needs Plans (D-SNPs) that are Applicable Integrated Plans (AIPs), where timing gaps in enrollment can delay alignment with an individual's Medicaid plan. These gaps may cause temporary coverage misalignment, member confusion, and risk plans’ compliance with CMS AIP requirements. In this letter, we outline the implications of this is