Bill > A3066

Introduced Session

This bill requires the Division of Medical Assistance and Health Services (division) in the Department of Human Services (department) to identity and implement certain improvements to the Medicaid Managed Long-Term Services and Supports (MLTSS) Program, and to report to the Legislature on those activities no later than 18 months after the effective date of the bill. The bill also requires the division to establish a public-facing report card for each of the managed care organizations (MCOs) that administer and coordinate the program under the Medicaid program. The MLTSS program uses MCOs to coordinate all long-term services and supports under Medicaid - whether at home, in an assisted living facility, in community residential services, or in a nursing home. Under the bill, the division is directed to conduct a review of the MLTSS Program. The review, at a minimum, is to include: 1) a survey and evaluation of the existing quality oversight measures in place used to assess the performance of MCOs; 2) an assessment of the State's barriers to transitioning Medicaid members enrolled in the MLTSS Program from nursing home to community settings; and 3) a nationwide study of MLTSS Program payment models that have high rates of success in transitioning members from nursing home to community settings. Following the completion of this review, the division is required to identify and implement improvements to the MLTSS Program based upon the division's findings. The improvements are also to include requiring managed care organizations to: 1) reduce care management caseloads for nursing home residents; 2) more frequently visit nursing home residents on a face-to-face basis; 3) annually review the preferences and clinical needs of members residing in nursing homes and to transition any member, as appropriate, to a community setting; and 4) establish a process for complex transitions from nursing home to community care. The bill also directs the division to establish, and update annually, a public-facing report card on the department's website for each MCO's administration and coordination of the MLTSS Program. Each report card is to provide user-friendly performance and quality rating information for use by the public. Any MLTSS Program reports prepared by the department are also be included on the same webpage as the report cards. The bill provides that the report card is to include the following information for each MCO: 1) the number of members enrolled in the MLTSS Program; 2) monthly disenrollment data within the MLTSS Program; 3) data on performance, quality, and compliance; 4) available member feedback and reviews; and 4) any additional information deemed appropriate by the Commissioner of Human Services.

AI Summary

Chris Tully (D)*, 

Introduced, Referred to Assembly Health Infrastructure Committee (on 01/13/2026)

Official Document