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Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Optional Language Applicable to Certain D-SNPs
This technical assistance tool is the last 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… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Requirements for All D-SNPs
This technical assistance tool is the first 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 requirementsand advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
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 AgencyContract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
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… (Integrated Care Resource Center)
Technical Assistance Tool | February 2024
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans
To operate in a state, a Dual Eligible Special Needs Plan(D-SNP) must hold a contract with the state Medicaid agency. Those state Medicaid agency contracts (SMACs) must all have at least certain minimum elements, and states can also add additional… (Integrated Care Resource Center)
Technical Assistance Tool | August 2020
Scripts for Medicare-Medicaid Plan (MMP) Enrollment Brokers Assisting Individuals with CARA Lock-In Indicators
The Comprehensive Addiction and Recovery Act of 2016 (CARA) included provisions that give Medicare Prescription Drug Plans and Medicare Advantage plans (including Medicare-Medicaid Plans (MMPs)) tools to address opioid overutilization. To implement… (Integrated Care Resource Center)
Technical Assistance Tool | August 2020
Medicare-Medicaid Plan (MMP) Enrollment Restrictions Resulting from the Comprehensive Addiction and Recovery Act of 2016 (CARA)
This technical assistance tool describes the regulation that allows Medicare plans that provide prescription drug coverage (including MMPs) to use drug management programs to limit access to certain controlled substances determined to be “… (Integrated Care Resource Center)
Technical Assistance Tool | December 2019
State Options and Considerations for Sharing Medicaid Enrollment and Service Use Information with D-SNPs
New federal rules released in April 2019 require that Dual Eligible Special Needs Plans (D-SNPs) must, at a minimum, coordinate the delivery of Medicare and Medicaid benefits. The final rule includes new regulatory language effective January 1, 2020… (Integrated Care Resource Center)
Technical Assistance Tool | January 2019
The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries
Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10… (Mathematica)
Technical Assistance Tool | April 2017
Tips for States Using Enrollment Brokers in the Capitated Financial Alignment Demonstrations: Beneficiary FAQs and Suggested Responses
This technical assistance tool lists questions frequently asked by beneficiaries enrolling in capitated Financial Alignment Initiative demonstrations, and provides potential responses by enrollment brokers' customer service representatives (… (Integrated Care Resource Center)
Technical Assistance Tool | December 2015
Training Enrollment Broker Call Center Staff: Tips for States Implementing Capitated Financial Alignment Demonstrations
This tool describes the key areas of information that demonstration enrollment brokers' customer service representatives should master to improve the quality of decision-support services for beneficiaries who are being passively enrolled in a… (Integrated Care Resource Center)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Consumer Protection
This technical assistance tool covers key issues in RFPs and contracts related to consumer protection including marketing, member materials and education, continuity of care, and grievance and appeals processes. (Integrated Care Resource Center)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Care Coordination
This technical assistance tool covers key issues in RFPs and contracts related to care coordination including the structure of the care team, development of care plans, caseload requirements, and use of a centralized enrollee record. (Integrated Care Resource Center)
Technical Assistance Tool | July 2013
Selected Provisions from Integrated Care RFPs and Contracts: Behavioral Health
This technical assistance tool covers key issues in RFPs and contracts related to behavioral health including coordination of behavioral health services, network availability of behavioral health services, and inclusion of behavioral health… (Integrated Care Resource Center)
Technical Assistance Tool | March 2013
Past Performance and RFP/RFR Language Options
This technical assistance tool provides states with options to evaluate health plans' past performance as they consider those plans for participation in their integrated Medicare-Medicaid programs. (Integrated Care Resource Center)