Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees.
Please see the attached memorandum entitled "Contract Year (CY) 2021 Notices for Applicable Integrated Plans: “Coverage Decision Letter”, “Letter about Your Right to Make a Fast Complaint” and “Appeal Decision Letter”" from Sharon Donovan, Director, Program Alignment Group, Medicare-Medicaid Coordination Office. The memorandum describes the notices available for D-SNPs that are applicable integrated plans.
This technical assistance tool provides tables describing both general and special election periods relevant to the enrollment of dually eligible indiviuals in drug management programs into Medicare Advantage plans, including Medicare--Medicaid Plans operating in demonstrations under the Financial Alignment Initiative.
Related Resources:
This memo provides information to Medicare Advantage organizations regarding the opportunity to transition enrollees in Dual Eligible Special Needs Plan (D-SNP) “look-alikes” for CY 2021.
This CMS memorandum describes the final Contract Year 2021 model notices for Dual Eligible Special Needs Plans that are applicable integrated plans, "Letter about Your Right to Make a Fast Complaint" and "Appeal Decision Letter", which are both available in English and Spanish language versions.
This memo provides answers to questions related to two CMS memos released on April 21 and April 23 for Medicare Advantage and Part D plans (including D-SNPs and Medicare-Medicaid Plans (MMPs)) describing guidance for plans related to the COVID-19 pandemic. This guidance contains several points of potential interest for states with integrated care initiatives.
This memo provides updated information related to previously issued April 21, 2020 guidance, "Information Related to Cronavirus Disease 2019 - COVID-19."
This memo provides information to PACE organizations to help control and prevent the spread of the virus to causes COVID-19.
In response to the spread of COVID-19, the Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency federal and state survey agency surveys. Consistent with that action, CMS is reprioritizing scheduled program audits for Medicare Advantage organizations, Part D sponsors, Medicare-Medicaid Plans, and PACE oganizations. Oversight will continue but will shift to prioritize the investigation and resolution of instances of noncompliance where the health and/or safety of beneficiaries is at risk and complaints allenging infection control concerns.