Aligning Enrollment

States using Dual Eligible Special Needs Plans (D-SNPs) as a platform for Medicare-Medicaid integration often try to promote aligned enrollment (i.e., enrollment of dually eligible individuals into a D-SNP and an affiliated Medicaid managed care plan offered by the same parent company in the same geographic area) to advance their integration efforts.

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• Selectively Contracting with D-SNPs to Promote Alignment With Medicaid Managed Care Plans

  This webinar explains the potential benefits for states of selectively contracting with D-SNPs, key building blocks for selective contracting, considerations for states when deciding to selectively contract with D-SNPs, and steps that states can take when implementing selective contracting. (ICRC, February 2023)

• Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Promoting Aligned Enrollment

  This tip sheet outlines tips for promoting aligned enrollment (i.e., enrollment of dually eligible beneficiaries in D-SNPs and Medicaid managed care plans offered by the same parent company in the same geographic area (aligned plans) as an integration tool. (ICRC, April 2018)

• Using Exclusively Aligned Enrollment to Integrate Medicare and Medicaid Benefits for Dually Eligible Individuals

  In this webinar, ICRC team members explain how exclusively aligned enrollment promotes integration of Medicare and Medicaid benefits for dually eligible individuals enrolled in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), describe three models that states can use to achieve exclusively aligned enrollment in D-SNPs, and outline key considerations and steps for states in designing and implementing exclusively aligned enrollment. (ICRC, June 2023)

• Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries

  This fact sheet summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. (ICRC, July 2019)

• Default Enrollment FAQ

  This document details a number of commonly asked questions regarding default enrollment. (MMCO, February 2019)

• Aligning Coverage for Dually Eligible Beneficiaries Using Default and Passive Enrollment

  This webinar provides a history of default enrollment and its requirements as well states’ roles in this process, including the need to identify beneficiaries newly eligible for Medicare. (ICRC, July 2018)

• 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. (MMCO, October 2018)