New Guidance from CMS on Serving Dual Eligibles

On December 19, 2018, the Centers for Medicare and Medicaid Services published a new State Medicaid Director Letter titled Ten Opportunities to Better Serve Individuals Dually Eligible for Medicaid and Medicare. In this letter, CMS spotlights ten different new and already existing ways states are able to pursue changes that could improve care for Medicare-Medicaid enrollees. Below is a list of those ten approaches. The letter provides further detail and guidance as to how states can pursue each.

1. State contracting with dual eligible special needs plans (D-SNPs)
2. Default enrollment into a D-SNP
3. Passive enrollment to preserve continuity of integrated care
4. Integrating care through PACE
5. Reducing the administrative burden in accessing Medicare data for use in care coordination
6. Program integrity opportunities
7. MMA file timing
8. State buy-in file data exchange
9. Improving Medicare Part A buy-in
10. Opportunities to simplify eligibility and enrollment

LeadingAge will review this new guidance further and provide analysis and additional information to members.

Article reposted from LeadingAge National.