Dual Eligible Special Needs Plans (D-SNPs)

State Options and Considerations for Sharing Medicaid Enrollment and Service Use Information with D-SNPs

New federal rules released in April 2019 require that Dual Eligible Special Needs Plans (D-SNPs) must, at a minimum, coordinate the delivery of Medicare and Medicaid benefits. The final rule includes new regulatory language effective January 1, 2020 and provides examples of ways that D-SNPs should coordinate their members’ Medicare and Medicaid services. This technical assistance brief discusses issues and options for states to support D-SNPs in meeting this requirement.

Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans

As of 2021, the contracts that Dual Eligible Special Needs Plans (D-SNPs) have with state Medicaid agencies must include not just the elements specified by the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, but also new language detailing the requirements issued by CMS in April 2019 to increase the level of Medicare and Medicaid coordination and integration provided by these plans. This technical assistance tool provides sample contract language that states can use in their D-SNP contract to comply with these requirements.

Information Sharing to Improve Care Coordination for High-Risk Dual Eligible Special Needs Plan Enrollees: Key Questions for State Implementation

This technical assistance tool offers key questions and considerations that states can review as they begin working with Dual Eligible Special Needs Plans (D-SNPs) and other parties to design and implement information-sharing requirements.

Promoting Information Sharing by Dual Eligible Special Needs Plans to Improve Care Transitions: State Options and Considerations

This brief examines the approaches used by three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their Dual Eligible Special Needs Plans (D-SNPs) that support care transitions. The brief includes examples of contract language and strategies to encourage plan collaboration and problem solving around information sharing. It can help states, D-SNPs, and other stakeholders assess how to meet the new D-SNP contracting requirements and improve the care of dually eligible individuals.

Working with Medicare Webinar | State Contracting with D-SNPs: Using D-SNPs to Integrate Care for Dually Eligible Individuals

Working with Medicare
12/17/2020

This is part two of a two part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to state staff who are new to or seek a refresher on D-SNP contracting and working with Medicare plans.

Webinar 2: Using D-SNPs to Integrate Care for Dually Eligible Individuals

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

Working with Medicare Webinar | State Contracting with D-SNPs: Introduction to D-SNPs and D-SNP Contracting Basics

Working with Medicare
12/14/2020

This is part one of a two part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to state staff who are new to or seek a refresher on D-SNP contracting and working with Medicare plans.

Webinar 1: Introduction to D-SNPs and D-SNP Contracting Basics

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

Integrated Care Updates- August 2020

Integrated Care Updates- August 2020

  •  New ICRC Resources on Comprehensive Addiction and Recovery Act of 2016 (CARA) Related Restrictions on Medicare-Medicaid Plan (MMP) Enrollment
  • MACPAC Releases Updated Inventory of Integrated Care Models
  • Want to Know More about the Dually Eligible Individuals in Your State? Request a State Data Profile
  • August 2020 Enrollment in Medicare-Medicaid Plans
  • August 2020 Enrollment in PACE Organizations
  • New Resources on the ICRC Website
  • Key Upcoming Dates

Spotlight: New ICRC Tools Help States Identify Dually Eligible Individuals and Aligned Enrollees

ICRC has released two new resources to help states identify both individuals who are (or who will soon be) dually eligible and dually eligible individuals who are enrolled in Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated” plans).

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