State Medicaid Action Steps to Promote Integration | Integrated Care Resource Center

For many states, the first steps toward advancing integrated care for their dually eligible populations could be taken by building a stronger foundation for Medicare-Medicaid integration. This entails making administrative changes to Medicaid programs that: (1) support integration efforts; (2) improve beneficiaries’ experience of care; (3) decrease beneficiary out-of-pocket costs; and (4) reduce provider burden. These changes, also described in a December 2018 State Medicaid Director Letter, include:

Establishing Medicare Part A Buy-In agreements with the Centers for Medicare & Medicaid Services (CMS)
Ensuring that state eligibility criteria for Medicare Savings Programs (MSPs) align with the Medicare Part D Low Income Subsidy Program
Supporting beneficiary enrollment into MSPs and Extra Help
Exchanging data files with CMS more frequently
Facilitating beneficiary access to services, such as durable medical equipment, to reduce fragmentation between the Medicare and Medicaid programs

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Frequently Asked Questions about Medicare Part A and B “Buy-in”

This document responds to the main policy questions submitted to CMS based on information in Chapter 1 of the updated Manual for State Payment of Medicare Premiums released on September 8, 2020. (CMS, March 2021)
Part A Buy-in Agreements for States - Q&A

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. (CMS, March 2019)
Assessing the Fiscal Viability of a Medicare Part A But-in Agreement in Group Payer States

This tool is designed to help states without Part A buy-in agreements – known as “group payer” states – understand how to use their own data to analyze the potential costs and benefits of entering into Part A buy-in agreements, which facilitate access to Medicare Part A and dual eligible status for individuals in the Qualified Medicare Beneficiary (QMB) eligibility group who must pay a premium for Part A and are not yet enrolled. (ICRC, December 2021)
Alignment of Medicare Savings Program Eligibility with the Medicare Part D Low Income Subsidy Program

This tip sheet details how states, by aligning their Medicare Savings Programs (MSPs) eligibility criteria with those used for the Medicare Part D Low-Income Subsidy (LIS) program, can easily use the Social Security Administration’s LIS “leads” data to automate and/or streamline enrollment into MSP benefits. (ICRC, May 2019)
Benefits of Daily versus Monthly Buy-in Data Exchanges for Medicaid Agencies

This document describes the benefits of daily data exchanges with CMS and addresses frequently asked questions on buy-in data exchanges. (CMS, August 2018)
Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State Approaches

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 using provisional prior authorization policies and online lists of DME that Medicare generally does not cover. (ICRC, June 2018)