WALA Submits Comments on 2025 Family Care / MCO Contract Amendment

2025 Family Care / MCO Contract Amendment

WALA submitted comments on the 2025 Family Care/Managed Care Organization (MCO) Contract Amendment which included the following:

• Removal of duplication of services as it pertains to care management. Specifically, a managed care organization (MCO) should not be required to provide the same care management services that an assisted living facility already provides - Two nurses providing two assessments on the same resident. This requirement creates a duplication of services that diminishes quality of care and increases costs.
• Room and Board Transparency. WALA requests full disclosure as it pertains to a Family Care member’s room and board obligation and that assisted living facilities do not receive reimbursement cuts due to room and board obligations.
• Pay for Performance. Any funding from Pay for Performance Initiatives should be provided directly to assisted living facilities.
• Risk Corridors. Recoupments by DHS from a MCO should be directed back to assisted living facilities as a directed payment.