Commonwealth Coordinated Care Member Survey

A VHCA online survey was launched on April 16th targeted to all member nursing facilities that are located within or adjacent to one of the five Commonwealth Coordinated Care regions.  The survey invitation was sent electronically to senior home office management for multi-facility organizations and to the administrator for freestanding nursing facilities.  We have requested that the online survey be completed no later than 5 PM on Tuesday, April 22nd.  No identifiable facility or organization information will be released or shared.

The survey requests information about two important areas:

  1. What is the status of provider agreement execution with each of the contracted health plans?
  2. How many Dual Eligibles reside in your facility with third party liability (Medigap/TRICARE) insurance coverage in place?

The federal Centers for Medicare and Medicaid Services (CMS) and Virginia's Department of Medical Assistance Services (DMAS) have initiated the launch of the dual eligible financial alignment demonstration - the Commonwealth Coordinated Care program (CCC).  Beginning April 1st, services to eligible duals that voluntarily enrolled in the CCC commenced in the Tidewater and Central/Richmond regions of the demonstration.  DMAS has reported that 50 nursing facility residents voluntarily enrolled in these initial two regions.

We are aware that a number of nursing facilities have not yet executed contracts with one or more of the three contracted health plans - Medicare-Medicaid Plans (MMPs).  As VHCA and its members continue to work with the MMPs and DMAS to address a number of operational issues prior to the July 1, 2014 program launch in the Tidewater region for passively (automatically) enrolled beneficiaries, it will be helpful to know more precisely what facilities have executed provider agreements with specific MMPs.

Additionally, as we've reported in recent issues of the CareConnection newsletter, some otherwise eligible beneficiaries with both Medicare and Medicaid benefits may be ineligible due to the fact that they have other comprehensive insurance coverage in place.  While there are likely additional types of insurance coverage that meet the criteria established by CMS and DMAS, the two common examples cited are Medigap policies and TRICARE military benefits.  For a more comprehensive review of this exception criteria, please see the Commonwealth Coordinated Care: Third Party Liability Coverage article in last week's CareConnection.

We ask that all member facilities located in or adjacent to one of the five CCC regions complete this important survey.  Please refer to the electronic invitation sent on April 16th for links to take the survey.  Members with questions should contact Hobart Harvey via email or by phone at 804.212.1695.