will deliver long-term services and supports and physical health benefits through capitated Medicaid managed care organizations (MCO). The CHC-MCOs will coordinate with Medicare and existing behavioral health HealthChoices MCOs to provide a holistic approach to services and supports. In order to transition to CHC, providers will enter into an agreement with a CHC-MCO and will be included in that CHC-MCO’s provider network. For a minimum of the first six months of the implementation of CHC, CHC-MCOs will be required to include all willing long-term services and supports providers in their network to ensure continuity of care for participants. Prior to implementation and during the six-month period, CHC-MCOs will contract with willing and qualified providers of all types to make up their provider networks. CHC-MCOs are required to create a provider network that meets the needs of their participants and allows participants to have choice in providers.
Prior to implementation of CHC in each region, DHS will hold an in-person regional event for providers to introduce CHC and the CHC-MCOs, and Southwest region providers should expect to receive details in the coming months.
Providers will also receive direct communications to inform them of actions that they need to take in order to continue providing services under this new model.
CHC will change the way some OBRA waiver participants get Medicaid services. The following provider groups received letters regarding the upcoming changes:
If you have questions or comments about the CHC program, please email RA-PWCHC@pa.gov