Oversight and Monitoring

How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance

The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans across multiple dimensions. CMS publishes the Star Ratings each year – usually in October -- to help beneficiaries find the best plan for them and to determine MA quality bonus payments to plans. The lowest-ranking plans receive one star, and the highest ranking plans receive five stars. The 2019 Star Ratings are now available on CMS’ website. 

Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight

This brief describes how states can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment, and other services, and incorporate that information into their audit and oversight activities.

State Monitoring and Oversight of Managed Long-Term Services and Supports Care Programs

Study Hall Call
September-14

In this presentation, an ICRC speaker describes the basic principles of MLTSS program oversight and state performance monitoring practices for Medicaid MLTSS programs. In addition, a speaker from Texas offers operational insight on oversight of the STAR+PLUS program.

State Perspectives on Contracting with Dual Eligible Special Needs Plan

Study Hall Call
February-15

This presentation highlights the ICRC technical assistance tool State Contracting with Medicare Advantage Dual Eligible Special Needs Plans: Issues and Options and features a moderated panel discussion among representatives of three states (Minnesota, New Jersey, and Tennessee) with a wide range of experience in contracting with D-SNPs.

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