News Report | January 11, 2021
Federal Review Finds Lax Oversight Of Medicaid Managed Long-Term Services & Supports Programs
A federal review of Medicaid managed long-term services and support (LTSS) programs in six states found both significant problems in managed care organization (MCO) performance of care management and lax oversight by states and the federal government. MCO care management inconsistently addressed beneficiary needs. Certain care management activities were routinely conducted, but the MCO’s follow-up actions to address needs were inconsistent. In some MCO health assessments, the relationship was not clear between the consumer’s identified needs and the service hours and type of services that the MCO authorized. All six states identified MCO performance problems ranging . . .