Our Issues

On July 22nd, the MLTSS Association met with Democratic staff from the Senate Finance Committee in response to their "Dear Colleague" letter on long-term care reform. During this meeting, the Association provided insight into key areas of interest for the Association, including the LTSS workforce, enabling technology, integrated care for dually eligible individuals, value-based contracting, and program integrity in MLTSS. The Association provided a leave-behind with additiona

On July 21st, the MLTSS Association submitted comments on CMS’s proposed rule on lowering Medicaid State-Directed Payment (SDP) limits for certain services beginning July 4, 2025, and extending those limits to all SDPs by January 1, 2029. SDPs have been a foundational feature of Medicaid managed care financing, permitting states to direct Medicaid managed care plans to make targeted provider payments that support state Medicaid goals and supplement reimbursement rates. In o

MLTSS can help to improve care coordination, enhance access to HCBS, and better align care for people with complex needs. This new resource reviews California's current In-Home Supportive Services (IHSS) carve-out, explores key considerations for integrating IHSS into MLTSS, and examines four state case studies that illustrate successful MLTSS models. It concludes with practical considerations and potential pathways for strengthening California's LTSS program.

In July, the MLTSS Association sent a letter to CMS outlining recommendations for the new standalone 1915(c)(11) waiver option allowing states to extend Home and Community Based Services (HCBS) to individuals who do not yet meet an institutional level of care (LOC) standard. MLTSS plans already deliver HCBS to people with complex and specialized healthcare needs under existing 1915 and 1115 frameworks, manage care coordination across the full continuum of LTSS, and possess

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