Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
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States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.
This guide describes the interface that states with Financial Alignment Initiative Demonstrations use to conduct Medicare eligibility verification and MMP enrollment submission to the CMS MARx systems. The MMP technical guide has been updated in… (Infocrossing)
Medicare-Medicaid Plan (MMP) Technical Guide to Eligibility and Enrollment Transaction Processing
This guide describes the interface that states with Financial Alignment Initiative Demonstrations use to conduct Medicare eligibility verification and… (Infocrossing)
This user guide, produced in September 2019, provides detailed instructions for state and MMP users on the new Infocrossing online interface that states and MMPs use to submit eligibility queries and enrollment transactions for Financial Alignment… (Infocrossing)
Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10… (Mathematica)
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
This brief assesses Washington State's oversight of Medicaid managed care plan performance under the state's 1915 (b) waiver by quantifying monitoring practices and comparing them to benchmarks inside and outside of Washington State.
This toolkit provides a practical guide to collecting, validating, and reporting Medicaid managed care encounter data and is designed as a guide for state Medicaid staff responsible for managing the daily operations involved in encounter data, as… (Mathematica)
This report examines how five states have structured the interface between MFP demonstration grants and Managed long-term services and supports (MLTSS) programs to promote transitions from institutional care to home- and community-based settings.
This website provides information on the Medicare-Medicaid Alignment Initiative -- the capitated model Financial Alignment Initiative in Illinois.
(Illinois Department of Healthcare and Family Services)