State Contracting Strategies

This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes.

This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record.

This technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health requirements in quality improvement programs.

This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs.

This brief provides an overview of managed care marketing requirements in both Medicare and Medicaid, highlights the different sets of rules, and outlines steps taken to better align them.

This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs.

This tool outlines CMS’ requirements and state contracting options under a variety of situations affecting D-SNPs.

This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) contract oversight and quality monitoring procedures.