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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 | May 2023
New and Departing Medicare Advantage (MA) Contracts with Dual Eligible Special Needs Plans (D-SNPs) in Calendar Year 2023, by State
This resource reflects the new and departing Dual Eligible Special Needs Plans for 2023, by State analysis. The analysis has the following tables and figures: Table that lists the new and departing D-SNPs in each state for CY2023 Table that lists… (Integrated Care Resource Center)
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 | 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 | July 2019
Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries
This fact sheet, updated in July 2019, summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. It also provides references to additional resources for more detail and… (Integrated Care Resource Center)
Technical Assistance Tool | January 2018
How States Can Monitor Dual Eligible Special Needs Plan Performance: A Guide to Using CMS Data Resources
This resource shows how states can use data from the Centers of Medicare and Medicaid to create tables, graphs, and figures and interpret their meaning in order to assess D-SNP performance. (Integrated Care Resource Center)
Technical Assistance Tool | September 2017
Medicare Advantage D-SNP Non-Renewals, Service Area Changes, Terminations, and New Entries: CMS Requirements and State Options
This tool outlines CMS' requirements and state contracting options under a variety of situations affecting D-SNPs. (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)