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Department of Health Care Finance - DHCF

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The LTCA is comprised of three divisions:


  1. Program Operations – primarily responsible for daily operations to ensure service delivery for both providers and beneficiaries for all long term care services and supports, with the exclusion of the IDD Waiver which is operated by the Department on Disability Services. Program operations also focuses on issue resolution, ensuring timeliness of prior authorizations, provision of training and technical assistance to providers, provider readiness and complaint triage and resolution.
  2. Oversight and Monitoring – primarily responsible for quality assurance of the agency’s long-term care programs (including compliance with six CMS assurances) and outcomes, including compliance with CMS assurances for performance of both waiver programs (ID/DD and EPD). This division also conducts oversight of LTCA providers through audits, site visits, and issuance and review of corrective action plans.
  3. Intake and Assessment – primarily responsible for programmatic eligibility and enrollment into LTCSS. This includes oversight of the LTCSS Contractor, quality assurance of the face-to-face assessment for LTCSS, level of care reviews, IDD acuity level reviews and approvals and participation in the fair hearings and appeals processes.