Our Issues

On July 31, the MLTSS Association submitted comments on CMS’s interim final rule on the implementation of Medicaid Community Engagement (CE) requirements. Overall, our comments focus on the areas where additional clarity would most improve implementation, particularly the accurate identification of individuals who qualify for the medically frail and caregiver exemptions. Our recommendations are grounded in a shared goal of implementing the statutory requirement in a way that

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

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

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.

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

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

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 launched a new workgroup focused on Self-Direction in MLTSS. This effort reflects the Association's commitment...

On September 22nd, the MLTSS Association submitted written comments to the New Hampshire LTSS study committee as they consider...

The MLTSS Association has created a brief that that highlights the intersection between behavioral health and long-term care needs. This...