(a) The commission shall require that a managed care organization participating in the pilot program:
(1) ensures that individuals participating in the pilot program have a choice among acute care and comprehensive long-term services and supports providers and service delivery options, including the consumer direction model;
(2) demonstrates to the commission’s satisfaction that the organization’s network of acute care, long-term services and supports, and comprehensive long-term services and supports providers have experience and expertise in providing services for individuals with an intellectual or developmental disability and individuals with similar functional needs;
(3) has a process for preventing inappropriate institutionalizations of individuals; and
(4) ensures the timely initiation and consistent provision of services in accordance with an individual’s person-centered plan.
(b) For the duration of the pilot program, the commission shall ensure that comprehensive long-term services and supports providers are considered significant traditional providers and included in the provider network of a managed care organization participating in the pilot program.


Text of section effective until April 01, 2025

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