Kaiser Family Foundation Survey on State Medicaid Managed Care ...

Table 13 continuedStateDescription of ArrangementDual eligibles must enroll in the KY Partnership (MCO) to receive Medicaid-only benefits, such asKentucky pharmacy and transportation. They do not have to choose a primary care provider within thePartnership network and they retain their Medicare freedom-of-choice.Dual eligibles may voluntarily enroll in Senior Care Options, which covers all Medicaid andMassachusetts Medicare benefits including primary, acute, pharmacy, behavioral health, community and facilitybasedservices and supports and care coordination.Michigan Dual eligibles must enroll in a behavioral health PHP.Enrollment in managed care is mandatory for most seniors. Medicaid-only seniors must enroll inMSC+. Dually eligible seniors may enroll in MSC+ or in MSHO. MSHO is an integratedMedicaid/Medicare product that includes health services as well as home and community-basedservices and a certain amount of nursing facility services. The state contracts for Medicaid serviceswith Medicare SNPs, so dual eligibles age 65 and older can receive all Medicaid and MedicareMinnesota services through a single MCO. Dual eligibles who are blind or disabled and age 18 to 64 mayvoluntarily enroll in Special Needs Basic Care, an integrated Medicaid/Medicare product thatincludes a certain amount of nursing facility services; personal care and home and communitybasedservices are available on a fee-for-service basis. Because the state contracts for Medicaidservices with Medicare SNPs, blind and disabled duals aged 18 to 64 can receive Medicaid andMedicare services through a single MCO.Dual eligibles may voluntarily enroll in the PCCM program and are enrolled statewide on an optoutbasis in addition to the voluntary enrollment. Also, the Community Care Networks haveNorth Carolinacontracted directly with CMS for a Section 646 Demonstration.New Jersey Dual eligibles may voluntarily enroll in the New Jersey <strong>Family</strong>Care program.New Mexico Dual eligibles must enroll in the managed long-term care program.Dual eligibles may voluntarily enroll in Medicaid Advantage, which offers a uniform Medicare AdvantageProduct and a supplemental Medicaid product that covers cost-sharing associated with MedicareNew YorkAdvantage, as well as inpatient mental health exceeding Medicare limits, limited non-Medicare-coveredhome care, non-emergency transportation, and dental care plan options.OregonDual eligibles may voluntarily enroll in OHP Plus.Dual eligibles must enroll in behavioral health PHP. Dual eligibles are not enrolled in MCOs or thePennsylvaniaPCCM program on either a voluntary or a mandatory basis.South Carolina Dual eligibles may voluntarily participate in the Medical Home Network (PCCM).Dual eligibles receiving Medicaid-reimbursed long-term care (LTC) services are enrolled in theCHOICES program. Enrollment is voluntary, but it is required in order to receive MedicaidreimbursedLTC services; thus, in effect, it is mandatory. In addition, all Medicaid-eligibleTennesseeindividuals (excluding PACE participants) are enrolled in a MCO for physical and behavioral healthservices. Two of the state's three MCOs also offer SNPs. At this time, TennCare has a CoordinationAgreement with existing SNPs, primarily for purposes of data exchange.STAR+PLUS is a Texas Medicaid program offered in four service areas that integrates the delivery ofacute care services and community-based long-term services and supports to aged, blind, anddisabled (ABD) Medicaid recipients through a managed care system. STAR+PLUS operates underTexasone 1915(b) and two 1915(c) waivers allowing the state to provide home and community-basedservices for Supplemental Security Income (SSI) eligible and SSI-related Medicaid clients, and tomandate managed care for clients aged 21 years and older. (Enrollment in STAR+PLUS is voluntaryfor clients aged 20 and younger.)Dual eligibles living in geographic areas where mandatory MCO enrollment is in place are requiredUtahto enroll in a health plan.Full dual eligibles (QMB-Plus and SLMB-Plus) may voluntarily enroll in the Washington MedicaidWashingtonIntegration Partnership (which operates in one county). Clients can opt-in or opt-out at any time.Wisconsin Dual eligibles may voluntarily enroll in SSI managed care plans.Note: Not all states provided data on their enrollment of dual eligibles in Medicaid managed care.46 00