Medicaid Managed Care - U.S. Senate Special Committee on Aging

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<strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> Program Characteristics
In States Enrolling Dually Eligible Persons
in Health Programs
State <strong>Medicaid</strong> DE Enrollment NF or LTC Service covered Connection to LTC Service System
Policy, Under Risk
AZ Mandatory tua LTC LTC system is risk-based and comprehensive &
. ti~~~~~~~~~~~~nked
to acuta rare system
CA Voluntary in all but 5 counties limited NFP LTC capitaled by in all but 3 counties. disenrolled trom risk after
state in 3 otfS mandatory cos 60 days NF care
CO Voluntary ULnited NF/no LTC LTC on FFS. remain in HMO tor health
FL Voluntary 6 months NF/no LTC cisenrolted trom risk after 6 mos NF
GA Voluntary no NP/no LTC disenrolled trom risk d enter NF
MD Voluntary no NP/no LTC disenrolled trom risk it enter NF
Ml Voluntary no NP/no LTC disenrolled trom risk i enter NF
MN/ Mandatory no NF/some home based care LTC on FFS. remain in HMO for health
PMAP
MN/ Voluntary 6 mo NF. and HCBC2 alter 6 mo NP: LTC on FFS. remain in HMO tor
MSHO health
NV Voluntary LTC up to StltOOtrindividual disenroted trom risk it cap is reached
NJ Voluntary no NF/no LTC disenrolled from risk it enter NF
NY Voluntary no NF/no LTC disenrolled from risk it enter NF
OR Mand. (Vol. tor some DE) United NF/no LTC LTC on FFS, remain in HMO tor health
PA Mand/Vol by geography Limted NF/no LTC disenrolled trom risk alter 30 days NF
TN Mandatory no N/no LTC LTC on PFFS remain in HMO tor health
L'T Mandatory Limited NF/no LTC HCBC recips stay in risk HMO; disenrolled trom
risk after 30 days NF
WlI/P Voluntary tull benefits LTC system is risk-based and comprehensive
WI/la Voluntary 90 days NF disenrolled trom risk after 90 days NF
1. Aftecting <strong>Medicaid</strong> services only.
2. HC8C = Home and Community Based Long Term <strong>Care</strong>
3. WI Partnership Program: NF-eligible elderly and disabled adults. All benetits coordinated by the program.
although particular long term care servires may be under tee tor servise.
4. WI I-<strong>Care</strong> Program Disabled Adults
National Academy for State Health Policy, 1997