Dual Eligible Special Needs Plans (D-SNPs)

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:

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.

Medicare 201: Actions States Can Take to Improve Quality and Coordination of Care for Dually Eligible Individuals

03/25/2021

This is part two a two-part Integrated Care Resource Center (ICRC) Working with Medicare webinar on Medicare 201 held on March 25, 2021.

This webinar provides an overview of integrated care pathways, how states can work with D-SNPs to design supplemental benefits offerings, and steps that states can take to improve coordination of care for dually eligible populations. The webinar is especially helpful to state staff who are new to or seek a refresher on Medicare.

Medicare 101: An Introduction to Medicare Benefits and the Roles of Medicare and Medicaid in Serving Dually Eligible Individuals

03/22/2021

This is part one of a two-part Integrated Care Resource Center (ICRC) Working with Medicare webinar on Medicare 101, held on March 22, 2021.

This webinar provides an overview of Medicare benefits, how Medicare and Medicaid benefits overlap and interact for dually eligible individuals, and steps that states can take to improve care for vulnerable dually eligible populations. The webinar is especially helpful to state staff who are new to or seek a refresher on Medicare.

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.

Working with Medicare Webinar | State Contracting with D-SNPs: Introduction to D-SNPs and D-SNP Contracting Basics

12/13/2022

This is part one of a two part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to state staff who are new to or seek a refresher on D-SNP contracting and working with Medicare plans.

Webinar 1: Introduction to D-SNPs and D-SNP Contracting Basics

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