Other E-alert

CMS Issues Memo to Medicare Advantage Plans to Encourage Continuity of Care for Dually Eligible Enrollees Currently Receiving Opioid Treatment Program Services through Medicaid

On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing a new opioid treatment program (OTP) benefit under Medicare Part B, starting January 1, 2020. 

OTP Part B Deductible Informational Bulletin and Tip Sheet

Centers for Medicare & Medicaid Services (CMS) issued an Informational Bulletin to provide guidance to states regarding coverage changes for dually eligible beneficiaries (those enrolled in both Medicare and Medicaid) receiving opioid treatment services, as well as a Tip Sheet for Opioid Treatment Program (OTP) Providers Serving Dually Eligible Individuals: State Coverage of the Medicare Part B Deductible.

New CMS Memo Summarizes Medicare-Medicaid Integration and State Contract Requirements for D-SNPs

This Spotlight highlights key takeaways from the CMS October  memo related to: (1) integration requirements that apply to all D-SNPs and the states in which they operate; and (2) requirements for unified appeals and grievances that apply to some D-SNPs and affiliated Medicaid managed care plans in states that limit D-SNP enrollment only to those individuals who receive their Medicaid benefits from an affiliated Medicaid plan. It also includes a table that highlights key features and differences between FIDE SNPs and HIDE SNPs

New ICRC Resource | Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans

ICRC has created a new technical assistance tool that provides sample contract language for each of the minimum SMAC elements required by the Medicare Improvements for Patients and Providers Act of 2008, as well as sample language designed to comply with the new requirements described in the April 2019 final rule.

Comments Sought on Proposed Process to Verify that D-SNP Contracts Meet New Information-Sharing Requirements for Contract Year 2021

On September 12, 2019, the Centers for Medicare & Medicaid Services (CMS) released the draft Contract Year 2021 Medicare Advantage-Prescription Drug Application for a 60-day public comment period. The draft MA-PD application shows how CMS proposes to collect information from Dual Eligible Special Needs Plans (D-SNPs) to verify that the plans will meet the new Medicaid integration requirements from the Bipartisan Budget Act of 2018 as codified in the April 2019 final rule (CMS-4185-F).


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