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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 - 13 of 13

Tip Sheet | February 2024
Integrating Dual Eligible Special Needs Plan Materials to Promote Enrollee Understanding of and Access to Benefits
Integrating Dual Eligible Special Needs Plan Materials to Promote Enrollee Understanding of and Access to Benefits Dual Eligible Special Needs Plans (D-SNPs) that operate with exclusively aligned enrollment and cover Medicaid benefits through the D-… (Integrated Care Resource Center)
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)
February 2019
CY 2019 MN MSHO Summary of Benefits (SB) model document
(Centers for Medicare & Medicaid Services/Minnesota Department of Human Services)
Tip Sheet | June 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Designing an Integrated Summary of Benefits Document
This tip sheet describes how states can start to improve member materials by using contractual requirements to ensure that Medicare and Medicaid benefit information for aligned plans is incorporated into a single, streamlined Summary of… (Integrated Care Resource Center)
Brief | June 2017
State and Health Plan Strategies to Grow Enrollment in Integrated Managed Care Plans for Dually Eligible Beneficiaries
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)
Study Hall Call | January 2015
Building and Validating LTSS Provider Networks
This presentation examines strategies for states establishing Medicaid MLTSS or integrated care programs to ensure that health plans develop LTSS provider networks to address beneficiaries' diverse needs. (Integrated Care Resource Center)
Study Hall Call | October 2014
Integrated Marketing Rules and Practices for Medicare and Medicaid Managed Care
This presentation provides an overview of the major differences between Medicare and Medicaid marketing requirements and opportunities for better alignment, and it also offers lessons from MassHealth's roll out of Massachusetts' integrated… (Integrated Care Resource Center)
Brief | July 2014
Moving Toward Integrated Marketing Rules and Practices for Medicare and Medicaid Managed Care Plans
This brief provides an overview of managed care marketing requirements in both Medicare and Medicaid, highlights the different sets of rules, and outlines steps taken to better align them. (Integrated Care Resource Center)
Other Resource | July 2014
Identifying Community-Based Resources: Key Considerations for Health Plans
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)
Other Resource | January 2014
Medicare Advantage Network Adequacy Requirements, D-SNPs, and State Contracting Options
This document summarizes a telephone discussion among states, CMS, the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage network adequacy requirements and their application to D-SNPs. (Integrated Care Resource Center)
Other Resource | December 2013
Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
This report spotlights the approaches used by five states - Arizona, Minnesota, Tennessee, Texas, and Wisconsin - to ensure managed care organizations are ready to provide care coordination services to consumers and adequate access to needed long-… (AARP Public Policy Institute)
Brief | July 2013
Developing Provider Networks for Medicaid Managed Long-Term Services and Supports Programs: Considerations for States
This brief presents considerations for provider network development, reviews recent guidance, and offers examples of state practices for establishing MLTSS network adequacy standards. (Center for Health Care Strategies)
May 2013
Transitioning Long Term Services and Supports Providers Into Managed Care Programs
This paper identifies concerns and considerations in incorporating traditional LTSS providers into a managed care program. (Truven Health Analytics)