Continuity of Care Requirements in the Managed Medical Assistance Program

The Statewide Medicaid Managed Care (SMMC) program consists of two components: the
Managed Medical Assistance (MMA) program and the Long-term Care (LTC) program. The
MMA program provides medical services to infants, children and adults on Medicaid, while the
LTC program provides home and community-based long-term care services to elders and adults
with disabilities on Medicaid who meet nursing home level of care. A key goal of the SMMC
program is ensuring that recipients experience continuity of care, meaning that recipients
experience no break in service coverage or care coordination while transitioning from one
service delivery system to another, one managed care plan to another, or from one service
provider to another. This document provides an overview of the continuity of care requirements
for the MMA program and the expectations established by contract for managed care plans and
providers. While continuity of care is a key goal during the implementation of the MMA
program, this concept is a standard requirement in the core managed care contracts and will
continue to apply after the initial implementation.

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