Background on Long-Term Services and Supports

State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative

Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible individuals. For the demonstrations under the Financial Alignment Initiative, the Centers for Medicare & Medicaid (CMS) and states incorporated ombudsman programs to help to resolve enrollees’ problems and alert Medicare-Medicaid Plans (MMPs), states, and CMS of emerging trends and issues.

Perspectives on Ombudsman Programs Serving Dually Eligible Individuals: Services Offered and Value Added


This webinar provides an overview of the role of ombudsman programs in integrated care programs serving dually eligible individuals. Using the ombudsman programs developed for the demonstrations under the Financial Alignment Initiative as an example, the webinar examines ways that states have structured these programs, the types of supports that they can offer, and the value they provide to both consumers and state Medicaid agencies.

Learning Objectives: By the end of this presentation, attendees should be able to: