DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
Center for Medicaid and CHIP Services 
CMCS Informational Bulletin  
 
DATE:           August 6, 2012 
 
FROM:   Cindy Mann, Director 
Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:   Medicaid Managed Long Term Services and Supports (MLTSS)Two New 
Resources on Medicaid.gov 
 
 
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the availability of two 
new resources on Medicaid managed long-term services and supports (MLTSS) to support states and 
other partners in enhancing the quality of these services.  
 
Increasing numbers of states are using MLTSSwhich is the delivery of long-term services and 
supports through capitated Medicaid managed care programs  as a strategy for expanding home- and 
community-based services, promoting community inclusion, ensuring quality and increasing 
efficiency.  The number of states with MLTSS doubled from 2004 to 2012, and increasingly states 
have been seeking technical assistance on design and implementation of these services. 
 
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, the Balancing Incentive Program, etc.  States and stakeholders have expressed an interest in 
learning more about MLTSS, and how new long-term service and support opportunities in the 
Affordable Care Act may be incorporated into an MLTSS program. 
 
2012 MLTSS Environmental Scan 
 
Between January and June 2012, CMS conducted a national environmental scan of Medicaid 
MLTSS. The scan included an inventory of all MLTSS programs that had been implemented as of 
June 2012, and a projection of future programs through January 2014. State-by-state results are 
included for current and projected programs. This report synthesizes the findings across states, 
reporting national enrollment, characteristics of contractors and multiple program features.  
 
Key highlights include significant growth in MLTSS from 8 states in 2004 to 16 in 2012. In addition 
to the number of States with MLTSS programs doubling, the number of persons receiving LTSS 
through managed care programs increased from 105,000 to 389,000. By 2014, the number of states 
projected to have MLTSS programs is 26.  The report describes the varying ways in which states 
have designed MLTSS arrangements: states have chosen to include and exclude different sub-
population groups and have chosen varying degrees of integration across services.  Some states have 
implemented capitated payments for limited Medicaid benefits, some for comprehensive Medicaid  
    CMCS Informational Bulletin, Page 2 
 
benefits, and some for comprehensive Medicaid and Medicare benefits.  For further information, visit 
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-
Systems/Medicaid-Managed-Long-Term-Services-and-Supports-MLTSS.html for the full report. 
 
Online Web Resource 
 
In an effort to enhance the availability and quality of MLTSS, CMS is releasing an online tool 
offering states guidance on program design, Medicaid authorities and other information relevant to 
the effective management of MLTSS. This online resource provides consistent, accessible technical 
assistance which will be updated as policy and practice in the growing field of MLTSS evolves. It 
also features links to information such as sample contracts, state examples of effective organizational 
structure to manage MLTSS, and other useful sources of information.   For more information, please 
visit http://www.medicaid.gov/mltss/.