This brief describes how D-SNPs can request and use CMS audit reports to oversee D-SNPs operating in their jurisdictions.
Related Publications for Technical Assistance Helps States Share Best Practices for Delivering Coordinated Care
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization OversightJun 30, 2018
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Designing an Integrated Summary of Benefits DocumentJun 26, 2018
This brief identifies ways that states can improve Dual Eligible Special Needs Plans (D-SNPs) member materials by using contractual requirements to ensure that Medicare and Medicaid benefit information for aligned plans is incorporated into a single, streamlined Summary of Benefits (SB) document.
Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System: Three State ApproachesJun 13, 2018
Beneficiaries who are dually eligible for Medicare and Medicaid often experience difficulties accessing durable medical equipment (DME), such as wheelchairs, in a timely manner.
How States Can Better Understand their Dually Eligible Beneficiaries: A Guide to Using CMS Data ResourcesMay 30, 2018
This technical assistance tool presents an overview of the various data sources available on the CMS Medicare-Medicaid Coordination Office website that may be useful to states in designing, developing, and refining programs that serve dually eligible beneficiaries.
Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Promoting Aligned EnrollmentApr 30, 2018
States are increasingly seeking ways to better integrate care for people dually eligible for Medicare and Medicaid, who are among the highest need and most expensive populations in either program due to a high prevalence of multiple chronic conditions, physical and behavioral health disabilities, and...
Using CMS Data to Understand D-SNP Market Trends and Performance, Dual Eligible Characteristics, and State Medicaid Managed Care ProgramsMar 27, 2018
Mathematica researchers from the Integrated Care Resource Center will provide information on D-SNP enrollment and market trends, including aligned enrollment; dual eligible beneficiary characteristics, including eligibility categories, such as full and partial duals, QMBs, SLMBs, etc.
Tips for States Using Enrollment Brokers in the Capitated Financial Alignment Demonstrations: Beneficiary FAQs and Suggested ResponsesApr 30, 2017
States that run capitated demonstrations under the Centers for Medicare & Medicaid Services’ Financial Alignment Initiative often contract with enrollment brokers to answer calls from beneficiaries about the demonstrations.
Training Enrollment Broker Call Center Staff: Tips for States Implementing Capitated Financial Alignment DemonstrationsDec 30, 2015
Many states implementing capitated model financial alignment demonstrations rely on their Medicaid enrollment brokers to provide information to potential enrollees in the demonstrations’ Medicare-Medicaid Plans.
Medicare Chronic Care Management Services Payment: Implications for States Serving Dually Eligible IndividualsNov 30, 2015
This brief identifies opportunities for states and their contracting plans that serve Medicare-Medicaid enrollees to align Medicare and Medicaid coverage of care management.
Technical Notes on a Microsoft Access Tool for Prioritizing the Daily Transaction Record ReportMar 30, 2015
This document describes a tool developed in Microsoft Access that states can use to help reconcile enrollment in the Medicare Advantage and Prescription Drug system with comparable information found in their own systems.
Moving Toward Integrated Marketing Rules and Practices for Medicare and Medicaid Managed Care PlansJul 30, 2014
This technical assistance brief provides an overview of Medicare and Medicaid managed care marketing requirements.