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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 72

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)
Webinars and Trainings, Study Hall Call | March 2021
Perspectives on Ombudsman Programs Serving Dually Eligible Individuals: Services Offered and Value Added
This webinar provides an overview of the role of ombudsman programs in integrated care programs serving dually eligible individuals. Using the ombudsman programs developed for the demonstrations under the Financial Alignment Initiative as an… (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)
Other Resource | July 2019
States’ Medicaid Fee-for-Service Durable Medical Equipment Payment Policies
To better inform analysis of existing policies and development of future policies that affect Medicaid payments, the Medicaid and CHIP Payment and Access Commission (MACPAC) released a compendium of each state’s fee-forservice DME policies along… (Medicaid and CHIP Payment and Access Commission)
Tip Sheet | June 2019
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Integrating Medicaid Managed Long-Term Services and Supports into D-SNP Models of Care
Dual Eligible Special Needs Plans (D-SNPs) must develop a model of care (MOC) that describes their enrollees’ characteristics and health and service needs as well as the plan’s care coordination and health risk assessment processes. Despite the… (Integrated Care Resource Center)
Other Resource | April 2019
Selected Characteristics of 10 States With the Greatest Change in Long-Term Services and Supports System Balancing, 2012–2016
This report provides a national overview of long-term services and supports (LTSS) rebalancing and highlights 10 states – Missouri, Massachusetts, New York, New Jersey, Connecticut, Colorado, South Carolina, Illinois, Nevada, and Arkansas… (Centers for Medicare & Medicaid Services)
Study Hall Call | March 2019
New MLTSS Assessment and Care Planning Quality Measures: Implementation Issues for States and Integrated Care Plans
This webinar describes four new quality measures specifically designed for use by Medicaid managed long-term services and supports (MLTSS) plans, which address comprehensive assessments, comprehensive care plans, shared care plans with primary… (Integrated Care Resource Center)
February 2019
CY 2019 MN MSHO Summary of Benefits (SB) model document
(Centers for Medicare & Medicaid Services/Minnesota Department of Human Services)
Other Resource | January 2019
Strategies to Support Dually Eligible Individuals’ Access to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
This Centers for Medicare & Medicaid Services (CMS) Informational Bulletin provides an additional strategy for states to support timely access to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for people dually eligible… (Centers for Medicare & Medicaid Services)
Brief | November 2018
Building a Stronger Foundation for Medicare- Medicaid Integration: Opportunities in Modifying State Administrative Processes
This brief describes several administrative changes that state Medicaid programs can make to: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider… (Integrated Care Resource Center)
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 2018
Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State Approaches
This brief describes how three states – California, Connecticut, and Illinois -- promote dually eligible beneficiaries’ access to durable medical equipment (DME) in a fee-for-service environment through the use of provisional prior authorization… (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)
Tip Sheet | June 2017
Four Steps for Managed Care Plans to Promote Person-Centered Planning in Self-Direction Models
This tip sheet suggests steps that managed care plans can take to ensure that case managers are effectively trained on approaches to promote person-centered planning in self-directed delivery models for home- and community-based services. (Integrated Care Resource Center)
June 2017
A Questionnaire to Assess Potential Representatives in Self-Direction Programs
This questionnaire helps individuals and health plan case managers to select an appropriate person to be informally designated as a representative decision-maker. (Integrated Care Resource Center)