Other Resource

Nursing Facility Case-Mix Payment Changes Informational Bulletin

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

Cooperative Agreement between Pennsylvania Dept. of Public Welfare and Medicare Advantage Health Plan

Contract Between State of New Jersey Department of Human Services Division of Medical Assistant and Health Services and _, Contractor (Article 10)

MassHealth Senior Care Options Contract for Senior Care Organizations by and Between the Executive Office of Health and Human Services and _

Idaho Medicare-Medicaid Coordinated Plan. Appendix A – To Idaho Medicaid Provider Agreement

Florida Agency for Health Care Administration, 2015 Standard D-SNP Contract Template, Attachment I and Appendices

State and MMP User Guides for MMP Enrollment Processing

Medicare-Medicaid Plan (MMP) Technical Guide to Eligibility and Enrollment Transaction Processing

This guide describes the interface that states with Financial Alignment Initiative Demonstrations use to conduct Medicare eligibility verification and MMP enrollment submission to the CMS MARx systems.

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Default Enrollment Model Notice

This resource is a model letter that D-SNPs have the option to use to meet CMS beneficiary notice requirements for default enrollment. All letters used will need to contain the required CMS disclaimers, materials ID and receive appropriate CMS approval prior to use.

Default Enrollment Option for Newly Medicare Advantage Eligible Medicaid Managed Care Plan Enrollees (formerly known as “Seamless Conversion Enrollment”)

Self-Direction of Home- and Community-Based Services: A Training Curriculum for Case Managers

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.