Working Toward Solutions for Integration: Updates from Guidance and Proposed Rules (Presentation)

Publisher: Washington, DC: SNP Alliance Fall Leadership Forum
Oct 18, 2018
Nancy Archibald, Erin Weir Lakhmani, and Michelle Herman Soper
Mathematica and colleagues from the Center for Health Care Strategies review Centers for Medicare & Medicaid Services guidance and proposed rules on state and health plan options to better integrate Medicaid and Medicaid services for dually eligible beneficiaries in managed care plans. The presentation reviews the benefits of having a single managed care plan provide both Medicare and Medicaid benefits for dually eligible beneficiaries, outlines how states and health plans can use “default enrollment” and “passive enrollment” options to achieve this kind of aligned enrollment, and summarizes policy approaches that selected states have used to achieve aligned enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) that are linked to companion Medicaid managed care plans operated by the same parent organization in the same geographic area.