As more states shift to managed long-term services and supports (LTSS) for their Medicaid programs, your organization may need to contract with health plans. Health plans may be accustomed to contracting for institutional-based acute care services but may not have

Your organization may be required to change billing practices upon contracting, or entering into an agreement, with a health plan. Submitting a formal medical billing claim form may be a new experience for your organization. Your organization may be used

Community-based resources may address the needs of members dually eligible for Medicare and Medicaid that are sometimes not met through formal relationships with providers. This is particularly relevant for health plans deploying navigation, care coordination, and peer support programs in-house.

As states expand managed long-term services and supports (LTSS) for their Medicaid enrollees, your health plan may need to engage or contract with a variety of LTSS providers, including existing licensed home and community-based service providers and direct service workers

Health plans increasingly will be required to manage, monitor, and oversee a broader range of services as more states contract for managed long-term services and supports (LTSS).  Oversight includes preventing fraud and abuse, which requires ensuring that the services billed

Health plans increasingly will be required to provide oversight for a broader range of services as more states contract for managed long-term services and supports.  These services may include personal care services delivered by direct service workers (DSWs).  Monitoring the