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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 76

Other Resource | January 2025
Medicare-Medicaid Plan (MMP) Technical Guide to Eligibility and Enrollment Transaction Processing
The Medicare and Medicaid Technical Guide is a reference document used by Financial Alignment Initiative demonstration states and their partner Medicare Advantage plans and enrollment brokers to use as a guide to process their enrollment and related… (Infocrossing)
Webinars and Trainings | August 2023
State Strategies for Encouraging Enrollment in Integrated Care Programs
This webinar discusses strategies states can use to encourage enrollment in integrated care programs, including communicating the value of integrated care to dually eligible individuals through direct outreach and education, partnering with SHIPs… (Integrated Care Resource Center)
Technical Assistance Tool | July 2023
Glossary of Terms Related to Integrated Care for Dually Eligible Individuals
This resource was updated in July 2023 to include updated definitions of Dual Eligible Special Needs Plans (D-SNPs), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), Highly Integrated Dual Eligible Special Needs Plans (HIDE SNPs), and… (Integrated Care Resource Center)
Tip Sheet | June 2023
Definitions of Different Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Types in 2023 and 2025
This resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version. Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use… (Integrated Care Resource Center)
Tip Sheet | May 2023
Tips to Help States Select Medicaid Managed Care Authorities as They Design Integrated Care Initiatives for Dually Eligible Individuals
This tip sheet summarizes key considerations for states trying to decide which pathway to use to advance Medicare-Medicaid integration, and which Medicaid managed care authority(ies) might best support that pathway. Although the tip sheet presents… (Integrated Care Resource Center)
February 2023
Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid
This report provides data on the characteristics of dually eligible individuals and information on their use of services and costs of care. (Medicare Payment Advisory Commission)
Tip Sheet, Other Resource | April 2022
Dually Eligible Individuals: The Basics
ICRC has developed a basic fact sheet on individuals who are dually eligible for Medicare and Medicaid. (Integrated Care Resource Center)
Technical Assistance Tool | December 2021
Fillable Tables for States Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
Technical Assistance Tool | December 2021
Assessing the Fiscal Viability of a Medicare Part A Buy-in Agreement in Group Payer States
States may execute a Medicare Part A buy-in agreement with the Centers for Medicare & Medicaid Services (CMS) to facilitate access to Medicare Part A and dual eligible status under the Qualified Medicare Beneficiary (QMB) eligibility group. This… (Integrated Care Resource Center)
Brief | March 2021
State Approaches to Developing and Operating Ombudsman Programs for Demonstrations under the Financial Alignment Initiative
Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible… (Integrated Care Resource Center)
Study Hall Call | August 2020
Medicare-Medicaid Plan (MMP) Enrollment Processing Updates Resulting from the Comprehensive Addiction and Recovery Act of 2016 (CARA)
On August 26, 2020 from 1:00-2:30 pm ET the Integrated Care Resource Center (ICRC) hosted a Study Hall Call on Medicare-Medicaid Plan (MMP) Enrollment Processing Updates Resulting from the Comprehensive Addiction and Recovery Act of 2016 (CARA… (Integrated Care Resource Center)
Technical Assistance Tool | August 2020
Scripts for Medicare-Medicaid Plan (MMP) Enrollment Brokers Assisting Individuals with CARA Lock-In Indicators
The Comprehensive Addiction and Recovery Act of 2016 (CARA) included provisions that give Medicare Prescription Drug Plans and Medicare Advantage plans (including Medicare-Medicaid Plans (MMPs)) tools to address opioid overutilization. To implement… (Integrated Care Resource Center)
Technical Assistance Tool | August 2020
Medicare-Medicaid Plan (MMP) Enrollment Restrictions Resulting from the Comprehensive Addiction and Recovery Act of 2016 (CARA)
This technical assistance tool describes the regulation that allows Medicare plans that provide prescription drug coverage (including MMPs) to use drug management programs to limit access to certain controlled substances determined to be “… (Integrated Care Resource Center)
Other Resource | August 2020
Medicare Enrollment Periods and Special Election Periods for Dually Eligible Individuals: Reference Tables
This technical assistance tool provides tables describing both general and special election periods relevant to the enrollment of dually eligible indiviuals in drug management programs into Medicare Advantage plans, including Medicare--Medicaid… (Integrated Care Resource Center)
Other Resource | May 2020
Data Analysis Brief: Managed Care Enrollment Trends among Dually Eligible and Medicare-only Beneficiaries, 2006 through 2018
This analysis examines trends in enrollment and eligibility for Medicare-Medicaid enrollees. (Centers for Medicare & Medicaid Services)