CMS Medicare Guidance, Rulemaking, and Public Comments

New CMS Memo Summarizes Medicare-Medicaid Integration and State Contract Requirements for D-SNPs

This Spotlight highlights key takeaways from the CMS October  memo related to: (1) integration requirements that apply to all D-SNPs and the states in which they operate; and (2) requirements for unified appeals and grievances that apply to some D-SNPs and affiliated Medicaid managed care plans in states that limit D-SNP enrollment only to those individuals who receive their Medicaid benefits from an affiliated Medicaid plan. It also includes a table that highlights key features and differences between FIDE SNPs and HIDE SNPs

CMS Releases Final Rule on D-SNP Integration and Integrated Appeals

On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) published new final rule for Medicare Advantage and Part D that implements provisions of the Bipartisan Budget Act of 2018 related to the integration of Medicare and Medicaid services and unification of Medicare and Medicaid grievance and appeals procedures by Dual Eligible Special Needs Plans (D-SNPs).

CMS' Medicare Advantage and Part D Rates and Guidance for Calendar Year 2020

On April 1, 2019, the Centers for Medicare & Medicaid Services (CMS) published the Final Call Letter and Rate Announcement outlining guidance for the 2020 plan year for Medicare Advantage (MA) plans, including Dual Eligible Special Needs Plans (D-SNPs) and Medicare-Medicaid Plans (MMPs) under the Financial Alignment Initiative.

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