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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 - 15 of 20

Other Resource | August 2022
Guidance for States Seeking to Leverage New Opportunities for Integrated Care Programs
This memorandum provides states with guidance on the process for working with the Centers for Medicare & Medicaid Services (CMS) to establish Dual Eligible Special Needs Plans (D-SNP)-only contracts and develop integrated materials. The Contract… (Centers for Medicare & Medicaid Services)
Other Resource | August 2020
Medicare Enrollment Periods and Special Election Periods for Dually Eligible Individuals: Reference Tables
This technical assistance tool provides tables describing both general and special election periods relevant to the enrollment of dually eligible indiviuals in drug management programs into Medicare Advantage plans, including Medicare--Medicaid… (Integrated Care Resource Center)
Other Resource | January 2020
Additional Guidance on CY 2021 Medicare-Medicaid Integration Requirements for Dual Eligible Special Needs Plans (D-SNPs)
This HPMS memo provides additional guidance and clarification on four topics related to new integration standards for Dual Eligible Special Needs Plans: (1) distinctions between fully integrated D-SNPs (FIDE SNPs) and highly integrated (… (Centers for Medicare & Medicaid Services)
Other Resource | October 2019
CY 2021 Medicare-Medicaid Integration and Unified Appeals and Grievance Requirements for Dual Eligible Special Needs Plans (D-SNPs)
This memo to all Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) summarizes the new calendar year (CY) 2021 requirements for Medicare-Medicaid integration. These requirements were detailed in an April 2019 CMS final rule and… (Centers for Medicare & Medicaid Services)
Other Resource | December 2018
A New Approach to Integrating Care for Dually Eligible Beneficiaries: Idaho’s Medicare Medicaid Coordinated Plan (MMCP)
This blog post looks at Idaho's Dual Eligible Special Needs Plan (D-SNP)-based program’s structure and highlights early successes and lessons for other states. Idaho’s approach may be interesting to states that want to integrate care, but do… (Center for Health Care Strategies)
Other Resource | April 2017
Identifying Newly Eligible Medicare-Medicaid Individuals for Enrollment in Capitated Financial Alignment Demonstrations: Frequently Asked Questions (FAQs)
This document answers questions that states have asked about improving the processes they use to regularly identify prospective Medicare-Medicaid individuals for potential enrollment into their capitated financial alignment demonstrations. (Integrated Care Resource Center)
Other Resource | June 2016
Data-Driven Strategies - Analyzing Opt-Outs and Engaging Beneficiaries and Providers
This document describes the process that states and health plans participating in the capitated financial alignment demonstrations use to submit information to CMS' MARx systems. (Centers for Medicare & Medicaid Services)
Other Resource | March 2016
Technical Notes on a Microsoft Access Tool for Prioritizing the Daily Transaction Record Report
This document describes a Microsoft Access tool to prioritize information in the MARx system Daily Transaction Reply Report, and it explains states can use it to improve the timeliness and efficiency of their demonstration enrollment processes. (Integrated Care Resource Center)
Other Resource | January 2016
Contract Between State of New Jersey Department of Human Services Division of Medical Assistant and Health Services and _, Contractor (Article 10)
(New Jersey Department of Human Services), (Division of Medical Assistance and Health Services)
Other Resource | January 2016
Idaho Medicare-Medicaid Coordinated Plan. Appendix A – To Idaho Medicaid Provider Agreement
(Idaho Medicaid)
Other Resource | October 2015
Report on Early Implementation of Demonstrations under the Financial Alignment Initiative
This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014. (RTI International)
Other Resource | May 2015
Experiences with Financial Alignment Initiative Demonstration Projects in Three States: Feedback from Enrollees in California, Massachusetts, and Ohio
This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations. (Medicaid and CHIP Payment and Access Commission)
Other Resource | January 2015
MassHealth Senior Care Options Contract for Senior Care Organizations by and Between the Executive Office of Health and Human Services and _
(MassHealth)
Other Resource | January 2015
Florida Agency for Health Care Administration, 2015 Standard D-SNP Contract Template, Attachment I and Appendices
(State of Florida Agency for Health Care Administration)
Other Resource | May 2014
Medicare Advantage D-SNP Contract Oversight and Quality Monitoring
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC about Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) contract oversight and quality monitoring procedures. (Integrated Care Resource Center)