Search for Resources | Integrated Care Resource Center

Displaying 1 - 15 of 18

Other Resource | January 2025
Medicare-Medicaid Plan (MMP) Technical Guide to Eligibility and Enrollment Transaction Processing
The Medicare and Medicaid Technical Guide is a reference document used by Financial Alignment Initiative demonstration states and their partner Medicare Advantage plans and enrollment brokers to use as a guide to process their enrollment and related… (Infocrossing)
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 | 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 | March 2019
Three New Opportunities to Test Innovative Models of Integrated Care for Individuals Dually Eligible for Medicaid and Medicare
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
Other Resource | March 2019
Care Coordination in Integrated Care Programs Serving Dually Eligible Beneficiaries – Health Plan Standards, Challenges and Evolving Approaches
This MACPAC report reviews and analyzes care coordination requirements in the managed care organization contracts of nine states participating in demonstrations under the Financial Alignment Initiative, 10 states that contract with Fully Integrated… (Medicaid and CHIP Payment and Access Commission)
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
Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees Preliminary Findings from the Washington MFFS Demonstration
This report provides preliminary data for the first 18 months of Washington's managed fee-for-service demonstration. It includes a description of the demonstration model, preliminary findings on eligibility and enrollment in the demonstration,… (RTI International)
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 | 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)