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Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Optional Language Applicable to Certain D-SNPs
This technical assistance tool is the last in a series of four tools that provide sample State Medicaid Agency Contract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Requirements for All D-SNPs
This technical assistance tool is the first in a series of four tools that provide sample State Medicaid Agency Contract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirementsand advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Requirements for Certain Types of D-SNPs
This technical assistance tool is the second in a series of four tools that provide sample State Medicaid AgencyContract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | January 2025
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans (D-SNPs): Optional Language Applicable to All D-SNPs
This technical assistance tool is the third in a series of four tools that provide sample State Medicaid Agency Contract (SMAC) language that states can use in contracts with D-SNPs to meet federal requirements and advance state goals regarding care… (Integrated Care Resource Center)
Technical Assistance Tool | February 2024
Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans
To operate in a state, a Dual Eligible Special Needs Plan(D-SNP) must hold a contract with the state Medicaid agency. Those state Medicaid agency contracts (SMACs) must all have at least certain minimum elements, and states can also add additional… (Integrated Care Resource Center)
Webinars and Trainings | February 2023
Selectively Contracting with Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) to Promote Alignment with Medicaid Managed Care Plans
This webinar explains the potential benefits for states of selectively contracting with D-SNPs, key building blocks for selective contracting, considerations for states when deciding to selectively contract with D-SNPs, and steps that states can… (Integrated Care Resource Center)
Working with Medicare | December 2022
Working with Medicare Webinar | State Contracting with D-SNPs: Introduction to D-SNPs and D-SNP Contracting Basics
This is part one of a two part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful to… (Integrated Care Resource Center)
Working with Medicare | December 2022
Working with Medicare Webinar | State Contracting with D-SNPs: Using D-SNPs to Integrate Care for Dually Eligible Individuals
This is part two of a two part series that provides an overview of state strategies for contracting with D-SNPs to improve care coordination and Medicare-Medicaid alignment for dually eligible enrollees. The webinars are especially helpful… (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)
Technical Assistance Tool | July 2022
Integrated Appeal and Grievance Processes for Integrated D-SNPs with “Exclusively Aligned Enrollment”
On April 16, 2019, CMS released a final rule that implements provisions of the 2018 Bipartisan Budget Act (BBA) requiring greater D-SNP integration, including integrated plan-level appeal and grievance processes for certain “applicable… (Integrated Care Resource Center)
Technical Assistance Tool | July 2022
Appeals and Grievances: Comparisons of Existing and New Integrated Processes for Individuals Enrolled in Applicable Integrated Plans
Beginning in 2021, Dual Eligible Special Needs Plans (D-SNPs) with exclusively aligned enrollment must begin using integrated appeals and grievance processes. The flowcharts in this resource are designed to help states, health plans, and… (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 | 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 | 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)