These documents are part of the requirements that the Centers for Medicare & Medicaid Services (CMS) and the California Department of Health Care Services (DHCS) will use to assess health plan readiness to implement the duals demonstration, which is pending federal approval.
- Updated Long-term Services and Supports Network Standards (1/24/13) This version has gone through two iterations of public comment with previous versions being release on August 6th and November 26th, 2012. It describes the specific requirements that will be incorporated into the Health Plan Readiness Tool. Based on additional stakeholder feedback, the LTSS standards have undergone further revision and refinement. The previous version of the LTSS standards required plans involvement and direct oversight of LTSS programs, which raised concerns that the State was somehow transferring its role as regulator to plans. There is also now a greater focus on service specific training for plan staff, in addition to, enhanced policies and procedures for communication between plans and providers, as well as beneficiaries and their representatives. These standards also will be required of health plans for the non-demonstration population receiving managed LTSS.
- LTSS STandards Round Comments (12/10/12)
- First draft Long-term Services and Supports Readiness Standards (Nov. 26, 2012) This document reflected significant stakeholder input received on the version released in August. It describes the specific requirements that will be incorporated into the Health Plan Readiness Tool. The LTSS standards have undergone revision and structural changes based on the stakeholder input, including reformatting from a table to paragraph format. These standards also will be required of health plans for the non-demonstration population receiving managed LTSS. Please note that the care coordination elements were removed and included in the care coordination standards document.