​Community HealthChoices

Operations Memoranda

The Office of Long-Term Living’s (OLTL’s) Community HealthChoices (CHC) Operations Memoranda are communications with the CHC Managed Care Organizations (MCOs) that provide guidance, instructions, or clarifications related to operational procedures in the administration of the CHC program. 

2024

Ops Memo Number(s)TitleDate Issued
CHC-MCO-2024-052024 Pay for Performance Program (P4P)Nov. 14, 2024
CHC-MCO 2024-042024 CHC Agreement Complaint, Grievance, Fair Hearing, and Denial Notices Template Revisions (REVISED August 2, 2024)June 4, 2024
CHC-MCO 2024-032024 Consumer Assessment of Healthcare Providers and Systems Home and Community Based Services (HCBS CAHPS) Survey (OBSOLETE April 10, 2025)June 4, 2024
2024 CHC MCO 2024-02​Participant Renewal of Medical Assistance Financial Eligibility​April 25, 2024
CHC-MCO 2024-012024 CHC Agreement Complaint, Grievance, Fair Hearing, and Denial Notices Template RevisionsJanuary 4, 2024

2023

Ops Memo Number(s)TitleDate Issued
CHC-MCO 2023-012023 CHC Agreement Complaint, Grievance, Fair Hearing, and Denial Notices Template RevisionsJanuary 10, 2023
CHC-MCO 2023-02Opioid Centers of Excellence (COE)January 12, 2023
CHC-MC0 2023-03Consumer Assessment of Healthcare Providers and Systems Home and Community-Based Services (HCBS CAHPS®) Survey (OBSOLETE June 4, 2024)May 12, 2023
CHC-MCO 2023-04Issuing the Notice of Functional Ineligibility at Nursing Facility (NF) ApplicationMay 19, 2023
CHC-MC0 2023-05Level of Care Redetermination ProcessJuly 11, 2023
CHC-MC0 2023-06Home and Community-Based Settings Final Rule (REVISED January 25, 2024)October 13, 2023
CHC-MCO 2023-07Home Accessibility Durable Medical Equipment (HADME) (REVISED May 13, 2024)October 13, 2023
CHC-MCO 2023-08Street MedicineNovember 15, 2023
CHC-MCO 2023-09Community HealthChoices (CHC) Home and Community-Based Services (HCBS) to Act 150 transfersNovember 15, 2023
CHC-MCO 2023-10When a New Functional Eligibility Determination (FED) is needed for a Home and Community-Based Services (HCBS) waiver applicationNovember 30, 2023
CHC-MC0 2023-11In Lieu of Services (ILOS) Development and Request ProceduresNovember 30, 2023

2022

Ops Memo Number(s)TitleDate Issued
CHC-MCO 2022-012022 CHC Agreement Complaint, Grievance, Fair Hearing, and Denial Notices Template RevisionFebruary 9, 2022
CHC-MCO 2022-03Enterprise Incident Management (EIM) Reporting System Changes due to the August 2022 EIM Quarterly ReleaseAugust 8, 2022

2021

Ops Memo Number(s)TitleDate Issued
CHC-MC0 2021-01Updates to Prior Authorization Requirements for Certain Services during the COVID-19 Public Health EmergencyJuly 15, 2021
CHC-MCO 2021-03Participant Transitions between Living Independence for the Elderly (LIFE) and Community HealthChoices (CHC) Long-Term Services and Supports (LTSS) (REVISED January 21, 2022)November 15, 2021
CHC-MCO  2021-04Financial Management Services (FMS) Reporting RequirementsDecember 16, 2021

2020

Ops Memo Number(s)TitleDate Issued
CHC-MCO 2020-01Need for Comprehensive Needs Reassessment Following a Lapse in Medical (MA) Long-Term Care (LTC) Eligibility (REVISED May 4, 2023)January 14, 2020
CHC-MCO 2020-02Participant Transfer from CHC to Office of Developmental Programs (ODP) Waiver, ODP Base (MRX) Services of Facility ( REVISED November 14, 2024)March 2, 2020
CHC-MCO 2020-03Compliance with Medical Assistance (MA) Long-Term Services and Supports (LTSS) Penalty Period RequirementsJuly 14, 2020
CHC-MCO 2020-04Housing Supports for CHC ParticipantsAugust 5, 2020
CHC-MCO 2020-06Type, Scope, Amount, Duration, and Frequency of ServicesNovember 13, 2020
CHC-MCO 2020-07Electronic Visit Verification (EVV) Compliance Procedures for the Participant-Directed ModelDecember 7, 2020

2019

Ops Memo Number(s)TitleDate Issued
CHC-MCO  2019-02Process for Notification to the Independent Enrollment Broker (IEB) of a Nursing Facility Ineligible (NFI) Dual Eligible Participant Who May Be Nursing Facility Clinically Eligible (NFCE) and Need Home and  Community-Based Services (HCBS)July 29, 2019
CHC-MCO 2019-03Provider Fee AssignmentSeptember 9, 2019
CHC-MCO 2019-04Nursing Home Transition (NHT) and new Nursing Facility (NF) to Home and Community-Based Services (HCBS) transition procedures (REVISED December 29, 2023)October 29, 2019
CHC-MCO 2019-05Circumstances When CHC-Managed Care Organizations (MCO) Must Transmit the Home and Community-Based Services (HCBS) Eligibility/Ineligibility/Change Form(PA 1768) (REVISED December 29, 2023)November 20, 2019
CHC-MCO 2019-06Continuity of Services for Participants Transitioning to the CHC Waiver from other Home and Community-Based Services (HCBS) ProgramsDecember 11, 2019
CHC-MCO 2019-072020 CHC Agreement Participant Template Revisions  (REVISED September 15, 2023)December 16, 2019

2018

Ops Memo Number(s)TitleDate Issued
CHC-MCO 2018-01Nursing Facility Services - Hospital Reserved Bed DaysApril 6, 2018
CHC-MCO 2018-02The Provision of Services in Personal Care Homes (PCH), Assisted Living Residences (ALR) and Domiciliary Care (Dom Care) Homes April 6, 2018
CHC-MCO 2018-03Nursing Facility (NF) Claims - Other Medical Expenses (OME)May 14, 2018
CHC-MCO 2018-04Exceptional Medical Equipment for Nursing Facility (NF) ResidentsMay 14, 2018
CHC-MCO 2018-05When Nursing Facilities (NF) Should Bill a CHC-Mangaed Care Organization (MCO), a Healthc\Choices (HC)-MCO, the Fee-for Service (FFS) Program, or a Hospice Provider June 25, 2018

Obsolete Memos

Ops Memo Number(s)TitleIssue Date
CHC-MCO 2019-051768 RevisionsJune 17, 2025
CHC-MCO 2020-052020 HCBS CAHPS Survey  (OBSOLETE September 14, 2021)September 8, 2020
CHC-MCO 2019-012019 HCBS CAHPS Survey (OBSOLETE September 8, 2020)November 13, 2019
CHC-MCO 2021-022021 HCBS CAHPS Survey (OBSOLETE May 4, 2022)September 14, 2021
CHC-MCO 2022-02Consumer Assessment of Healthcare Providers and Systems Home and Community-Based Services (HCBS CAHPS®) Survey (OBSOLETE May 12, 2023)May 4, 2022