Managed Long-Term Services and Supports

Acronym: MLTSS

Managed Long Term Services and Supports (MLTSS) refers to the delivery of long term services and supports through capitated Medicaid managed care programs. Increasing numbers of states are using MLTSS as a strategy for expanding home- and community-based services, promoting community inclusion, ensuring quality, and increasing efficiency. MLTSS offers states a broad and flexible set of program design options and may be used as an overarching structure to promote initiatives such as Money Follows the Person, participant-directed services, and the Balancing Incentive Program. States and stakeholders have expressed an interest in learning more about MLTSS and how new Long-Term Services and Supports (LTSS) opportunities in the Affordable Care Act may be incorporated into an MLTSS program. Medicaid MLTSS programs can be operated under multiple federal Medicaid managed care authorities at the discretion of the state and as approved by CMS, including 1915a, 1915b, and 1115. There are requirements and limitations related to each authority, and managed care authority can be combined with other home and community based authorities to operate the MLTSS program (as with a concurrent 1915(b)/1915(c), for example).