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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.

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Displaying 1 - 15 of 115

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 | October 2024
QMB Billing HPMS memo
This Centers for Medicare & Medicaid Services (CMS) Health Plan Management System (HPMS) memorandum reminds Medicare plans of their obligation to educate network providers, suppliers, and pharmacies about, and ensure compliance with, QMB billing… (Centers for Medicare & Medicaid Services)
Other Resource | June 2024
Lessons Learned from Dual Eligible Special Needs Plans Enrollee Advisory Committee Strategic Conversation
Other Resource | March 2023
Key 2023 Medicare Advantage Dates
This calendar of key Medicare Advantage (MA) dates was developed to assist states and health plans in the implementation of integrated care programs for people dually eligible for Medicare and Medicaid. For a complete list of MA and Part D… (Integrated Care Resource Center)
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)
Tip Sheet, Other Resource | April 2022
Dually Eligible Individuals: The Basics
ICRC has developed a basic fact sheet on individuals who are dually eligible for Medicare and Medicaid. (Integrated Care Resource Center)
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 | 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 | 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 | June 2020
Dual Eligible Special Needs Plan (D-SNP) “Look-Alike” Transitions for Contract Year (CY) 2021
This memo provides information to Medicare Advantage organizations regarding the opportunity to transition enrollees in Dual Eligible Special Needs Plan (D-SNP) “look-alikes” for CY 2021. (Centers for Medicare & Medicaid Services)
Other Resource | May 2020
Data Analysis Brief: Managed Care Enrollment Trends among Dually Eligible and Medicare-only Beneficiaries, 2006 through 2018
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees. (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 | May 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides answers to questions related to two CMS memos released on April 21 and April 23 for Medicare Advantage and Part D plans (including D-SNPs and Medicare-Medicaid Plans (MMPs)) describing guidance for plans related to the COVID-… (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Updated Guidance for Medicare Advantage Organizations
This memo provides updated information related to previously issued April 21, 2020 guidance, "Information Related to Cronavirus Disease 2019 - COVID-19." (Centers for Medicare & Medicaid Services)
Other Resource | April 2020
Announcement of Calendar Year (CY) 2021 Medicare Advantage (MA) Capitation Rates and Part C and D Payment Policies
This memo describes the annual capitation rate for each Medicare Advantage payment area for CY 2021 and the risk and other factors to be used in adjusting these rates. (Centers for Medicare & Medicaid Services)