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.
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)
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)
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)
This webinar provides a history of seamless conversion and describes the new process for default enrollment that will start in 2019. This webinar also explains states’ roles in this process, including the need to identify beneficiaries newly… (Integrated Care Resource Center)
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)
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 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)
This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and… (Integrated Care Resource Center)
This questionnaire helps case managers to assess the ability of an individual to self-direct services, and if the individual requires assistance from a representative.
(Integrated Care Resource Center)
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker.
(Integrated Care Resource Center)
This resource suggests topics to be covered in a policies and procedures manual for the day-to-day management of the self-direction program. Programs should add topics as needed to ensure efficient and consistent program operations.
(Integrated Care Resource Center)
This document offers the Centers for Medicare & Medicaid Services' (CMS) guidelines for permissible goods and services, and can be customized to include additional state guidelines.
(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)