States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.
Starting January 1, 2021, Coordination Only (CO) Dual Eligible Special Needs Plans (D-SNPs) are required to notify the state Medicaid agencies that they contract with (or the states' designees) of hospital and skilled nursing facility admissions for… (Center for Health Care Strategies)
This Centers for Medicare & Medicaid Services (CMS) Health Plan Management System (HPMS) memorandum reminds Medicare plans of their obligation to educate network providers, suppliers, and pharmacies about, and ensure compliance with, QMB billing… (Centers for Medicare & Medicaid Services)
This document presents plan and state-level enrollment in three types of integrated care plans/programs that operate with exclusively aligned enrollment:
Medicare-Medicaid Plans (MMPs) that operate within demonstrations offered under the Financial… (Integrated Care Resource Center)
The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to evaluate the performance of Medicare Advantage (MA) health plans. This Star Rating system enables beneficiaries, payers, and others to compare plans… (Integrated Care Resource Center)