Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid
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.
This memo describes the annual capitation rate for each Medicare Advantage payment area for CY 2021 and the risk and other factors to be used in adjusting these rates.
In response to the unique circumstances resulting from D-SNPs’ and states’ priority focus on reducing the risks of COVID-19 transmission and maintaining continuity of operations, this memorandum outlines updated CMS processes for review and approval of state Medicaid agency contracts (SMACs) for contract year 2021. The goal is to provide D-SNPs and states with as much additional time as possible to execute contracts consistent with these new regulatory requirements prior to the January 1, 2021, effective date.
This calendar of key Medicare dates was developed to assist states and health plans in the implementation of integrated Medicare and Medicaid programs for people dually eligible for Medicare and Medicaid.[i] For a calendar showing all Medicare Advantage and Prescription Drug plan dates for calendar year 2020 and early 2021, see: https://www.cms.gov/files/document/cy-2021-medicare-parts-c-and-d-annual-calendar-2132020.pdf.
