Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
This webinar provides an update on new information-sharing requirements for Dual Eligible Special Needs Plans (D-SNPs) for 2021 and a review of key questions and considerations for states in working with D-SNPs to modify state contracts and develop a state-specific information-sharing approach.
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 memo to all Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) summarizes the new calendar year (CY) 2021 requirements for Medicare-Medicaid integration. These requirements were detailed in an April 2019 CMS final rule and must be incorporated into CY 2021 contracts with states that D-SNPs are required to submit to CMS by July 6, 2020.
This blog post looks at Idaho's Dual Eligible Special Needs Plan (D-SNP)-based program’s structure and highlights early successes and lessons for other states. Idaho’s approach may be interesting to states that want to integrate care, but do not have Medicaid managed long-term services and supports (MLTSS) programs.
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.
This tip sheet outlines tips for promoting aligned enrollment in states looking to integrate care for dually eligible beneficiaries using contracting strategies that maximize the opportunity for Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care (MMC) plans. With aligned enrollment, the beneficiary is enrolled in a D-SNP and MMC offered by the same parent company in the same geographic area (aligned plans).
This brief outlines a variety of actions that states and health plans can take to support enrollment growth in integrated care programs.