Case Study 2: Consumer Direction

Later that day, Tom and Meredith called Mary at the CMS regional office.

We currently offer a self-directed option in all of our HCBS waivers. If we roll those services into our MLTSS program like we were discussing last time I called, can we also roll in the consumer-directed options?

Based on your review of the Authorities section, can the state use their existing authorities to include self-directed options in the MLTSS program?

Yes, but if the enrollees choose the self-directed option, the state will have to disenroll them from managed care and serve them separately in fee-for-service.

Yes, the state can include self-directed options in its MLTSS program and require contractors to offer it as a choice and administer it when its chosen.

No, self-direction is not allowed under this state's existing authorities.

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