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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 20

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)
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)
Webinars and Trainings, Working with Medicare | March 2021
Medicare 201: Actions States Can Take to Improve Quality and Coordination of Care for Dually Eligible Individuals
This is part two a two-part Integrated Care Resource Center (ICRC) Working with Medicare webinar on Medicare 201 held on March 25, 2021. This webinar provides an overview of integrated care pathways, how states can work with D-SNPs to… (Integrated Care Resource Center)
Webinars and Trainings, Working with Medicare | March 2021
Medicare 101: An Introduction to Medicare Benefits and the Roles of Medicare and Medicaid in Serving Dually Eligible Individuals
This is part one of a two-part Integrated Care Resource Center (ICRC) Working with Medicare webinar on Medicare 101, held on March 22, 2021. This webinar provides an overview of Medicare benefits, how 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 | 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)
Tip Sheet | May 2019
Alignment of Medicare Savings Program Eligibility with the Medicare Part D Low Income Subsidy Program
The Medicare Savings Programs (MSPs) are Medicaid programs (or categories of Medicaid eligibility) that provide payment for Medicare premiums and/or cost sharing for low-income individuals. This tip sheet details one way a state can improve the… (Integrated Care Resource Center)
Brief | February 2018
Preventing Improper Billing of Medicare-Medicaid Enrollees in Managed Care: Strategies for States and Dual Eligible Special Needs Plans
This brief describes the ongoing problem of improper billing of protected dually eligible beneficiaries for Medicare cost-sharing and describes steps states and health plans can take to address it. (Integrated Care Resource Center)
Other Resource | September 2017
Key Medicare Advantage Dates and Action Items for States Contracting with Dual Eligible Special Needs Plans
This calendar of key Medicare Advantage dates describes program milestones by month and explains what activities state Medicaid agencies may want to undertake to prepare for or respond to a particular Medicare Advantage event. (Integrated Care Resource Center)
Brief | June 2017
Medicare Basics: An Overview for States Seeking to Integrate Care for Medicare-Medicaid Enrollees
This brief - updated from the 2013 version - is designed to help states better structure and coordinate the Medicaid benefits they offer to Medicare-Medicaid enrollees by providing them with basic information on the Medicare program, the services it… (Integrated Care Resource Center)
Brief | January 2016
Interdisciplinary Care Teams for Medicare-Medicaid Enrollees: Considerations for States
This brief describes key considerations for developing interdisciplinary care teams and explores how eight states addressed issues such as engaging providers and measurement approaches. (Center for Health Care Strategies)
Brief | January 2016
Communicating Early Results of Integrated Care Efforts for Dually Eligible Individuals: State Approaches
This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories. (Center for Health Care Strategies)
Study Hall Call | December 2015
Provider Engagement and Incentives in Care Management
This presentation features promising practices for information sharing and building relationships between providers, plans, and the state of Minnesota to optimize care management. (Integrated Care Resource Center)