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.
New federal rules released in April 2019 require that Dual Eligible Special Needs Plans (D-SNPs) must, at a minimum, coordinate the delivery of Medicare and Medicaid benefits. The final rule includes new regulatory language effective January 1, 2020… (Integrated Care Resource Center)
To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Ohio is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare & Medicaid… (Integrated Care Resource Center)
This brief examines the approaches used by three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their Dual Eligible Special Needs Plans (D-SNPs) that support care transitions. The brief… (Integrated Care Resource Center)
To provide more integrated, coordinated care for its residents who are dually eligible for Medicare and Medicaid, Washington State is operating a demonstration under the Financial Alignment Initiative offered by the Centers for Medicare &… (Integrated Care Resource Center)
This webinar provides background on the technical operations updates to Medicare enrollment transactions and processing for dually eligible beneficiaries related to the changes from the Medicare Part C/D final rule released on April 2, 2018. The… (Integrated Care Resource Center)
This tip sheet outlines tips for promoting aligned enrollment in states looking to integrate care for dually eligible beneficiaries using contracting strategies that maximize the opportunity for Medicare Advantage Dual Eligible Special Needs… (Integrated Care Resource Center)
This webinar describes the retroactive submission process, including how to use CMS' Electronic Retroactive Processing Transmission (eRPT) application to transmit enrollment transactions to the Retroactive Processing Contractor.
(Integrated Care Resource Center)
This brief outlines a variety of actions that states and health plans can take to support enrollment growth in integrated care programs.
(Integrated Care Resource Center)
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)
This technical assistance tool lists questions frequently asked by beneficiaries enrolling in capitated Financial Alignment Initiative demonstrations, and provides potential responses by enrollment brokers' customer service representatives… (Integrated Care Resource Center)
This webinar describes an opportunity identify prospective Medicare-Medicaid enrollees for enrollment into capitated financial alignment demonstrations and provides perspectives from Massachusetts and Michigan on states' use of this process.… (Integrated Care Resource Center)
This webinar features state experiences using data-driven strategies to analyze opt-outs and engage beneficiaries and providers in financial alignment demonstrations.
(Integrated Care Resource Center)
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)
This presentation introduces state enrollment staff to a tool to help prioritize transaction reply codes and simplify enrollment reconciliation.
(Integrated Care Resource Center)
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)