The Office of Long-Term Living (OLTL) has been in communication with the Centers for Medicare and Medicaid Services (CMS), to make emergency amendments to its Home and Community-Based Waivers in response to COVID-19. Members should refer to the document that was issued to the Community Health Choices Managed Care Organizations (CHC-MCOs), which contains the temporary changes that are to be implemented immediately.
On June 30, 2019, the continuity of care period for long-term services and supports (LTSS) for Phase II (southeast region) ended. As a result, Community HealthChoices (CHC) is now live in this region of the state. Providers should be aware of questions this may generate from CHC participants, such as a change to their service coordinator or a change they may experience with the services they receive (amount, duration, or frequency).
A CHC Managed Care Organization (MCO) must notify the Office of Long-Term Living (OLTL) in writing of its intent to terminate contracts with a provider, and services that a provider offers, 90 days before the termination’s effective date. Procedures to address the termination’s impact on participants should be in place and participants must be notified in writing 45 days before the effective date.
OLTL will continue to monitor notification requirements, service plan changes, service denial notices, complaints, and grievances despite the continuity of care period ending. CHC-MCOs will be held accountable for meeting notification requirements to ensure participants are properly informed and continue to receive necessary services without unexpected disruption.
Participants with questions or concerns about changes to services or service delivery should contact their CHC-MCO. If questions remain after talking with their CHC-MCO, participants can contact OLTL at 800-757-5042.
There are resources available to answer questions, etc. including a fact sheet, a question and answer document, and online training.
