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Community Co-Stars Incentive Program Frequently Asked Questions (FAQ)

This program is effective April 1, 2025

As of April 1, 2025, the Community Co-Stars Program provides an incentive payment of $300 per qualified transition member, per month to Assisted Living Facilities (ALF) for helping our members live in a community setting after they transition from a custodial nursing home. The member must have transitioned from a custodial nursing home and remained in the ALF without readmitting to the nursing facility. Incentive payments are paid monthly.

Incentive Calculation Examples

  • If a qualified member remained in an ALF for a minimum of 16 days each month for 12 months the facility will be paid $300 every month for a total of $3,600.
  • If a qualified member transitioned to an ALF on Nov. 1 and remained in the ALF each month until the member passed away on March 12, 5 monthly payments of $300 for a total of $1,500.

On a monthly basis, Sunshine Health will determine if an ALF provider has a qualified member who has remained in the ALF as described in this FAQ and is eligible for the incentive. Providers will be sent a separate monthly check for incentives earned. The memo line in the check will note “Community Co-Stars incentive.” Providers can find details on members who qualified and for which the payment is made through our Secure Provider Portal. Once logged in, click Reports. Providers will need to select the applicable TIN and Medicaid Plan type for their account and the report will populate (see illustration).

Welcome screenshot highlighting Reports tab

Login and select “Provider” from the “I am a” field, and click Submit. Select Create New Account. For additional guidance, see Secure Provider Portal How-To (PDF).

The Secure Provider Portal provides tools and functions to help you verify coverage eligibility, track your incentive payments, and identify member care gaps.

Yes. To ensure checks are sent to the correct address, email a current W-9 to Sunshine Health at sunshine_accounts_pa@centene.com

If the member passes away during the month, the period that the member remained in the ALF will be considered. The ALF will receive $300 for the month if payment criteria was met.

The Agency for Health Care Administration (AHCA) manages the ongoing eligibility of Medicaid members. AHCA may determine that the member is eligible and retrospectively re-enroll the member in Sunshine Health’s Long Term Care product. In this case, the ALF provider will be paid for that period if the member has remained in the ALF each month.

If a qualified member is transitioned from one ALF to another that is not under the same tax identification number (TIN), the new ALF would not be eligible for this incentive. The original ALF will be paid an incentive based on the stay in that facility according to the guidelines set forth in this FAQ.

We will consider these members as a part of the new Community Costars program effective April 1, 2025. Providers will be eligible to receive up to 12 months of Community Costar incentive payments from the Members original date of transition to the ALF and if Monthly payment criteria continue to be met.

If you have questions or want information, please call Provider Services at 1-844-477-8313, Monday-Friday, 8 a.m. to 8 p.m. Eastern or use the Find Your Provider Engagement Account Manager Tool.