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This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment models; (2) managed fee-for-service Financial Alignment models; and (3) state-specific models. 

This blog post looks at Idaho's Dual Eligible Special Needs Plan (D-SNP)-based program’s structure and highlights early successes and lessons for other states. Idaho’s approach may be interesting to states that want to integrate care, but do not have Medicaid managed long-term services and supports (MLTSS) programs.

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 for Medicaid and Medicare. The Informational Bulletin clarifies that states do not need to require a Medicare denial for DMEPOS that Medicare routinely denies as non-covered under the Medicare DME benefit.

This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.

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 transactions in line with CMS requirements with the assistance of Infocrossing LLC. 

In 2017, there were 12 million individuals dually eligible for Medicare and Medicaid. This fact sheet provides information on their reasons for Medicare eligibility, costs of care, and enrollment in managed care as well as the proportion of these beneficiaries who receive their care through arrangements that integrate their Medicare and Medicaid benefits.

This document provides answers to states' frequently asked questions about Medicare Part A Buy-in. It describes the advantages to states of having a Buy-in agreement and how these agreements can help to promote access to integrated care for dually eligible individuals.

This informational bulletin informs states of two changes that may impact states’ payments for Medicaid beneficiaries in the nursing home setting.

The ability to direct and manage their own services and supports is important to many individuals who need the home- and community-based services (HCBS) provided through state Medicaid programs. These self-directed models may also be known as "consumer direction" and "participant direction" when referring to specific states' programs. In these models, individuals direct many or all of their own HCBS, including selecting and managing direct service workers and/or managing a budget (known in some states as a service cost maximum) for needed services.