NSCLC: What’s In A Notice? How Notices Of Action Protect Consumers In Medicaid Managed Long-Term Services And Supports

From our colleagues at NSCLC: 

As Managed Long Term Services and Supports (MLTSS) rolls out nationwide, advocates on the ground have seen due process violations in appeals and notices of action. In this tool for advocates and consumers, NSCLC focuses on notice and appeal rights in MLTSS.  NSCLC provides background information on notices of action, including an explanation of what type of Managed Care Organization (MCO)  behavior constitutes an action that could give rise to due process violations.

This tool also provides advocates with the specific information that must be included in each notice of action to meet due process requirements, and outlines how continuation of services and aid-paid-pending plays out in the managed LTSS context.  Practice and advocacy tips based upon recent experiences in Kansas, Florida, and New Jersey as those states transitioned to MLTSS are included on issues of individual and systemic advocacy. 

Continue reading here: http://www.nsclc.org/wp-content/uploads/2014/11/Advocates-Guide-for-Notices-in-Medicaid-Managed-LTSS.pdf

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