Update on MLTSS

February 14, 2016

Providers are suddenly being “pursued” by various health plans who may be interested in bidding on the RFP for MLTSS which will be released this Spring to become operational by January 2017.  As part of this program, vendors who are not currently operating a Medicare Special Needs Plan for dual-eligible (D-SNP) in Virginia will be required to obtain a D-SNP certification within two years of the contract award.  In order to do so, they must have a provider network for their Medicare services.  DMAS is requiring vendors to have signed letters of intent from providers in order to submit proposals.

Individuals enrolled in ICF-IID facilities or in the ID, DD or DS Waivers now or in the redesigned versions on July 1st will continue as Medicaid fee-for-service until the “redesign” is complete; the services, therefore, that most of the VNPP Members provide will continue as fee-for-service.

It is not clear to this writer what services, if any, most VNPP members would have to offer to a D-SNP.  We are pursuing conversations with DMAS for clarification.  More information is available at http://www.dmas.virginia.gov/Content_pgs/mltss-home.aspx