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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 26

Other Resource | June 2024
Lessons Learned from Dual Eligible Special Needs Plans Enrollee Advisory Committee Strategic Conversation
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 | 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)
Other Resource | April 2020
Updated CMS Processes for Dual Eligible Special Needs Plan (D-SNP) Implementing CY 2021 Medicare-Medicaid Integration and Unified Appeals and Grievance Requirements in Response to Coronavirus Disease 2019 (COVID-19)
In response to the unique circumstances resulting from D-SNPs’ and states’ priority focus on reducing the risks of COVID-19 transmission and maintaining continuity of operations, this memorandum outlines updated CMS processes for review and approval… (Centers for Medicare & Medicaid Services)
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)
Tip Sheet | June 2017
Four Steps for Managed Care Plans to Promote Person-Centered Planning in Self-Direction Models
This tip sheet suggests steps that managed care plans can take to ensure that case managers are effectively trained on approaches to promote person-centered planning in self-directed delivery models for home- and community-based services. (Integrated Care Resource Center)
Tip Sheet | June 2017
Tips for States to Advance Person-Centered Planning in Self-Direction Models
This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and… (Integrated Care Resource Center)
June 2017
A Questionnaire to Assess Potential Representatives in Self-Direction Programs
This questionnaire helps individuals and health plan case managers to select an appropriate person to be informally designated as a representative decision-maker. (Integrated Care Resource Center)
Technical Assistance Tool | June 2017
Roles and Responsibilities in a Self-Direction Program
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker. (Integrated Care Resource Center)
June 2017
A Questionnaire to Assess Individuals' Ability to Self-Direct Services
This questionnaire helps case managers to assess the ability of an individual to self-direct services, and if the individual requires assistance from a representative. (Integrated Care Resource Center)
June 2017
Representatives' Responsibilities in a Self-Direction Program
This document describes the purpose and qualifications of representatives. (Integrated Care Resource Center)
June 2017
Policies and Procedures Manual Topics for a Self-Direction Program
This resource suggests topics to be covered in a policies and procedures manual for the day-to-day management of the self-direction program. Programs should add topics as needed to ensure efficient and consistent program operations. (Integrated Care Resource Center)
June 2017
Permissible Goods and Services in a Self-Direction Program
This document offers the Centers for Medicare & Medicaid Services' (CMS) guidelines for permissible goods and services, and can be customized to include additional state guidelines. (Integrated Care Resource Center)