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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.

Displaying 1 - 6 of 6

Technical Assistance Tool | July 2022
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 Care Resource Center)
Technical Assistance Tool | July 2022
Appeals and Grievances: Comparisons of Existing and New Integrated Processes for Individuals Enrolled in Applicable Integrated Plans
Beginning in 2021, Dual Eligible Special Needs Plans (D-SNPs) with exclusively aligned enrollment must begin using integrated appeals and grievance processes. The flowcharts in this resource are designed to help states, health plans, and… (Integrated Care Resource Center)
Brief | November 2018
Building a Stronger Foundation for Medicare- Medicaid Integration: Opportunities in Modifying State Administrative Processes
This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider… (Integrated Care Resource Center)
Brief | June 2018
Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State Approaches
This brief describes how three states – California, Connecticut, and Illinois -- promote dually eligible beneficiaries’ access to durable medical equipment (DME) in a fee-for-service environment through the use of provisional prior authorization… (Integrated Care Resource Center)
Study Hall Call | September 2014
Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative
This presentation highlights issues with overlapping coverage for home health services and durable medical equipment (DME), and describes the Health Plan of San Mateo's approach to coordinating these services, including operating protocols,… (Integrated Care Resource Center)
Brief | April 2014
Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative
This brief outlines challenges caused by the overlap in Medicare and Medicaid coverage for home health services and durable medical equipment and describes options for addressing these issues in the Financial Alignment Initiative and other… (Integrated Care Resource Center)

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Displaying 1 - 6 of 6

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

Appeals and Grievances: Comparisons of Existing and New Integrated Processes for Individuals Enrolled in Applicable Integrated Plans

Building a Stronger Foundation for Medicare- Medicaid Integration: Opportunities in Modifying State Administrative Processes

Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State Approaches

Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative

Improving Coordination of Home Health Services and Durable Medical Equipment for Medicare-Medicaid Enrollees in the Financial Alignment Initiative