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CMS Invites Comments on Draft Manual for State Payment of Medicare Premiums

REMINDER: Comments due February 29, 2020.

On December 13, the Centers for Medicare & Medicaid Services (CMS) released a draft Manual for State Payment of Medicare Premiums (formerly called the “State Buy-in Manual”) to states and other stakeholders for review and comment. The draft manual updates information and instructions to states on federal policy, operations, and systems concerning the payment of Medicare Parts A and B premiums (or buy-in) for individuals dually eligible for Medicare and Medicaid.

CMS Releases Additional Guidance on D-SNP Integration Requirements

On January 17, 2020, the Centers for Medicare & Medicaid Services (CMS) issued additional guidance and clarification on four topics related to CY2021 requirements for Dual Eligible Special Needs Plans (D-SNPs). The guidance follows on an October 2019 an HPMS memo summarizing the new D-SNP requirements and providing guidance on contract and operational changes needed for CY2021.

Top Scoring Medicare-Medicaid Plans on Overall Rating of Health Plan: A Snapshot from the 2019 CAHPS Survey

Under the Medicare-Medicaid Financial Alignment Initiative, the Centers for Medicare & Medicaid Services (CMS) is measuring consumer experience in multiple ways, including through beneficiary surveys such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS). As part of the MA-PD CAHPS survey, respondents are asked to rate their health plan on a scale from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible.

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


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