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DHS Responds to PA Hospitals Questions as Community HealthChoices Rollout Nears

December 15, 2017

The Pennsylvania Department of Human Services (DHS) is on track to implement Phase One of Community HealthChoices (CHC), Pennsylvania’s new Managed Long-Term Services and Supports (MLTSS) program in 14 southwestern counties on January 1, 2018.

DHS has been working with providers, insurers, consumers, and other stakeholders to create a coordinated infrastructure and process to support this new program. HAP conducted multiple provider education sessions and facilitated discussion around specific operational challenges as needed. As the “go-live” date got closer, some specific questions were still outstanding.  HAP invited Office of Long Term Living Chief of Staff Kevin Hancock to a December 14 meeting of HAP members where he answered hospital questions.

Some of the key discussion points included:

  • DHS monitoring and oversight during implementation and on-going
  • Clarification about “grandfathered” nursing facility participants
  • CHC impact on participants Medicare coverage

CHC is designed to help older Pennsylvanians and individuals with physical disabilities remain in their homes instead of going to facilities for care. CHC will provide coverage for people who are 21 or older and have both Medicare and Medicaid, or receive long-term supports through Medicaid. About 80,000 people are expected to be part of Phase 1, but when CHC is fully implemented (2020), about 420,000 Pennsylvanians will be enrolled.

Phase Two is scheduled to begin in southeast counties starting January 1, 2019, and Phase Three will begin January 1, 2020, for the remainder of the state.

For additional information, contact Jolene Calla, HAP’s vice president, health care finance and insurance.

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