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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 - 5 of 5

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)
Technical Assistance Tool | June 2017
Roles and Responsibilities in a Self-Direction Program
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker. (Integrated Care Resource Center)
Technical Assistance Tool | April 2014
Selected Provisions from Integrated Care RFPs and Contracts: Participant Direction
This technical assistance tool covers key issues in the development of requests for proposal (RFPs) and contract provisions related to participant-direction options in Medicaid managed LTSS (MLTSS) or integrated Medicare and Medicaid programs. (Integrated Care Resource Center)
Technical Assistance Tool | October 2013
Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports
This tool is a road map for states to use in interpreting and applying existing External Quality Review protocols when assessing Medicaid MLTSS program compliance. (Centers for Medicare & Medicaid Services)

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Displaying 1 - 5 of 5

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

Roles and Responsibilities in a Self-Direction Program

Selected Provisions from Integrated Care RFPs and Contracts: Participant Direction

Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports