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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 - 8 of 8

Other Resource | November 2020
Contract Year (CY) 2021 Notices for Applicable Integrated Plans
Please see the attached memorandum entitled "Contract Year (CY) 2021 Notices for Applicable Integrated Plans: “Coverage Decision Letter”, “Letter about Your Right to Make a Fast Complaint” and “Appeal Decision Letter”" from Sharon Donovan, Director… (Centers for Medicare & Medicaid Services)
Other Resource | July 2020
Proposed Addendum to the Part C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance
Public comments are requested on an addendum to the Part C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance. Commentors should use the template provided. (Centers for Medicare & Medicaid Services)
Other Resource | May 2020
Contract Year 2021 Models for Applicable Integrated Plans: 'Letter about Your Right to Make a Fast Complaint' and 'Appeal Decision Letter'
This CMS memorandum describes the final Contract Year 2021 model notices for Dual Eligible Special Needs Plans that are applicable integrated plans, "Letter about Your Right to Make a Fast Complaint" and "Appeal Decision Letter", which are both… (Centers for Medicare & Medicaid Services)
Other Resource | March 2020
Reprioritization of PACE, Medicare Parts C and D Program, and Risk Adjustment Data Validation (RACV) Audit Activities
In response to the spread of COVID-19, the Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency federal and state survey agency surveys. Consistent with that action, CMS is reprioritizing scheduled program audits for… (Centers for Medicare & Medicaid Services)
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)
Other Resource | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs. (Integrated Care Resource Center)
Other Resource | December 2013
Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
Other Resource | July 2012
Keeping Watch: Building State Capacity to Oversee Medicaid Managed Long-Term Services and Supports
This study examines how eight state Medicaid agencies, experienced in overseeing these programs, monitor the performance of plan contractors to ensure they provide optimal care to enrollees. (AARP Public Policy Institute)