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.
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)
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)
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)
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)
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)
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)
This webinar provides an overview of the Administration for Community Living's initiative to improve the business acumen of community-based organizations (CBOs) and features perspectives from a CBO and a health plan on building contractual… (Integrated Care Resource Center)
This presentation describes the new Medicare hospice payment rules and system updates that states will need to make to comply with the rules.
(Centers for Medicare & Medicaid Services)
This issue brief details four considerations that community-based organizations (CBOs) need to address when assessing the feasibility of participating in a managed long-term services and supports program: (1) relevant skill set and experience; (2)… (National Association of States United for Aging and Disabilities)
This fact sheet for health plans lists community-based resources and how they may help to address the needs of Medicare-Medicaid enrollees.
(Resources for Integrated Care)
This report details development of quality indicators for individuals receiving home- and community-based services.
(Agency for Healthcare Research and Quality)
This brief discusses strategies for structuring rates for managed long-term services and supports programs to encourage the use of home- and community-based services and details states experiences in setting rates for these programs.
(Center for Health Care Strategies)