Dual Eligible Special Needs Plans (D-SNPs)

Update on State Contracting with D-SNPs: The Basics and Meeting New Federal Requirements for 2021

Working with Medicare
07/09/2019

This webinar provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. Special attention is given to new federal D-SNP integration standards for 2021 contract year, and how states can help plans to meet these requirements.

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

Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Integrating Medicaid Managed Long-Term Services and Supports into D-SNP Models of Care

Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the importance of Medicaid services to dually eligible enrollees, D-SNPs are only required to describe Medicare services in their MOCs. However, states may require D-SNPs to develop an integrated MOC that describes not just how Medicare services will be provided, but also how the plan will provide and/or coordinate Medicaid benefits.

Webinar Resources | D-SNP Performance Monitoring and Oversight

On April 18, 2019, ICRC hosted a Study Hall Call on “D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources” that highlighted ways for states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). In this webinar, presenters give an overview of the Centers for Medicare & Medicaid Services’ (CMS) publicly available D-SNP performance monitoring resources and share approaches used by Oregon and Tennessee to incorporate performance monitoring and oversight requirements into D-SNP contracts.

D-SNP Performance Monitoring and Oversight: State Experiences and CMS Resources

Study Hall Call
04/18/2019

This webinar covers resources and strategies available to states to begin or improve their oversight of Dual Eligible Special Needs Plans (D-SNPs). Presenters provide an overview of the Centers for Medicare & Medicaid Services’ (CMS) publicly available D-SNP performance monitoring resources and share approaches used by Oregon and Tennessee to incorporate performance monitoring and oversight requirements into D-SNP contracts.

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).

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