Commonwealth Coordinated Care Update

On May 28th, the Department of Medical Assistance Services (DMAS) communicated that problems had been discovered in the beneficiary assignment approach utilized to assigned dual eligibles to an individual Medicare-Medicaid Plan (MMP) within the Tidewater region of the Commonwealth Coordinated Care (CCC) program.  As a result, it appears that an unspecified number of individuals now receiving services in nursing facilities located within the Tidewater region will receive letters from the CCC enrollment broker, Maximus, indicating that they have been reassigned to a new MMP.  Based upon earlier DMAS projections of the number of dual eligible beneficiaries receiving nursing facility services in Tidewater, we estimate that as many as 600 individuals could be subject to the MMP reassignment.  The May 28th communication indicates that for the individuals being reassigned, their CCC coverage will begin August 1, 2014, one month later than previously announced.  The DMAS communication does not indicate how, or if, providers will be notified about which of their residents have been reassigned.

The DMAS announcement further indicates that the effective date for the start of coverage for beneficiaries automatically or passively enrolled in the Richmond/Central CCC region has been moved back one month to September 1, 2014.  Launch dates in the three remaining CCC regions remain the same.