Dual Eligible Special Needs Plans (D-SNPs)

Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Requirements for Certain Types of D-SNPs

This technical assistance tool is the second in a series of four tools that provide sample State Medicaid Agency
Contract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care coordination, eligibility and enrollment, data reporting, marketing and enrollee communications, or other requirements regarding D-SNP activities.

Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Optional Language Applicable to All D-SNPs

This technical assistance tool is the third in a series of four tools that provide sample State Medicaid Agency Contract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care coordination, eligibility and enrollment, data reporting, marketing and enrollee communications, or other requirements regarding D-SNP activities.

This tool provides optional SMAC sample language applicable to all types of D-SNPs.

Using Exclusively Aligned Enrollment to Integrate Medicare and Medicaid Benefits for Dually Eligible Individuals

In this webinar, ICRC team members explain how exclusively aligned enrollment (EAE) promotes integration of Medicare and Medicaid benefits for dually eligible individuals enrolled in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), describe three models that states can use to achieve exclusively aligned enrollment in D-SNPs, and outline key considerations and steps for states in designing and implementing exclusively aligned enrollment.

Learning Objectives: By the end of this presentation, attendees should be able to:

Tools for States on Exclusively Aligned Enrollment in Dual Eligible Special Needs Plans: Introduction to Exclusively Aligned Enrollment

This tip sheet provides a brief overview of exclusively aligned enrollment, as well as a summary of the benefits of EAE for dual eligible special needs plan (D-SNP) enrollees, providers, and states.

New and Departing Medicare Advantage (MA) Contracts with Dual Eligible Special Needs Plans (D-SNPs) in Calendar Year 2023, by State

This resource reflects the new and departing Dual Eligible Special Needs Plans for 2023, by State analysis. The analysis has the following tables and figures:

Leveraging Dual Eligible Special Needs Plan (D-SNP) Models of Care to Enhance Enrollee Care Coordination

04/20/2023

This webinar will discuss strategies states can use to improve care coordination for D-SNP enrollees. It provides an overview of federal D-SNP care coordination and Model of Care (MOC) requirements, describes state options for incorporating care coordination requirements into state Medicaid agency contracts (SMACs) with D-SNPs, and/or requiring D-SNPs to incorporate state-specific information into MOCs, and discusses key considerations for states when implementing state-specific care coordination requirements.

Guidance for States Seeking to Leverage New Opportunities for Integrated Care Programs

This memorandum provides states with guidance on the process for working with the Centers for Medicare & Medicaid Services (CMS) to establish Dual Eligible Special Needs Plans (D-SNP)-only contracts and develop integrated materials.

Integrated Appeal and Grievance Processes for Integrated D-SNPs with “Exclusively Aligned Enrollment”

On April 16, 2019, CMS released a final rule that implements provisions of the 2018 Bipartisan Budget Act (BBA) requiring greater D-SNP integration, including integrated plan-level appeal and grievance processes for certain “applicable integrated plans.” This fact sheet is intended to help states with applicable integrated plans understand the new integrated appeal and grievance processes, the types of D-SNPs that are required to use them, and steps that states can take to help ensure effective implementation of the new processes in 2021.

Integrated Care Updates- August 2020

New ICRC Resources on Comprehensive Addiction and Recovery Act of 2016 (CARA) Related Restrictions on Medicare-Medicaid Plan (MMP) Enrollment
MACPAC Releases Updated Inventory of Integrated Care Models
Want to Know More about the Dually Eligible Individuals in Your State? Request a State Data Profile
August 2020 Enrollment in Medicare-Medicaid Plans
August 2020 Enrollment in PACE Organizations
New Resources on the ICRC Website
Key Upcoming Dates

Spotlight: New ICRC Tools Help States Identify Dually Eligible Individuals and Aligned Enrollees

ICRC has released two new resources to help states identify both individuals who are (or who will soon be) dually eligible and dually eligible individuals who are enrolled in Dual Eligible Special Needs Plans (D-SNPs) and Medicaid managed care plans owned by the same parent company (“affiliated” plans).