Elder & Disability Law - Managed Long-Term Services and Supports

Managed Long-Term Services and Supports: Winning Fair Hearing and Appeal Strategies
 
On July 1, 2014, New Jersey transitioned Medicaid long-term services and supports (LTSS) to managed care under its new demonstration waiver, the Comprehensive Medicaid Waiver.  Under the new waiver, the managed care plans are required to reassess approximately 11,000 HCBS waiver participants  as well as screen new applicants for LTSS.  During this process, some long-standing Medicaid LTSS recipients are finding their services reduced or terminated altogether.  In some cases, recipients are being told that their current service plan exceeds the cost thresholds under the new waiver.  New applicants are finding the process to get services in place difficult to navigate.  This interactive workshop will focus on concrete fair hearing and appeal strategies.  We will look at constitutional due process protections that must be afforded to all Medicaid consumers from the Notice of Action through the hearing itself.  We will look at discovery issues and unpack the new managed care contract provisions for MLTSS.  Come prepared to share ideas.