MLTSS Update

July 27, 2016

We received the following today from DMAS:

“We have received several questions regarding the timing of providers contracting with prospective MLTSS health plans.  As stated in the May 19, 2016 Medicaid Memo, DMAS will select MLTSS managed care plans through a request for proposals (RFP) competitive procurement process. The RFP submission required interested health plans to include their preliminary network, including signed contracts or letters of intent (LOIs) as part of their proposal. As explained in the Memo, MCOs will be required to submit their final networks based upon signed contracts with credentialed providers. (The credentialing process can take 90-120 days or more to complete.) The MLTSS RFP, explains that following evaluation of the proposals, two or more of the top ranked plans for each region will be selected for negotiations.  During negotiations, selected plans will go through an extensive readiness review process that includes review of the plans’ final networks.  For this reason, providers can expect to receive requests for signed contracts from health plans with whom DMAS selects for negotiation beginning in September 2016.  DMAS will continue to keep providers informed about MLTSS activities through updates posted on the DMAS MLTSS webpage.  These updates will include information about plans with whom DMAS selects for negotiations.”

Remember  that ID/DD Waiver services are NOT included as part of this project.  While the individuals supported in these services will begin to receive their primary and acute medical care from the selected MCOs the provider network will not include ID/DD Waiver providers. 

As soon as the negotiations begin we will try to coordinate with the selected plans to ensure that there is maximum consistency in format, procedures, training requirements, etc.