Resource: New Brief on Medicare / Medicaid Dual Eligible Special Needs Plans

ANCOR is sharing this brief by the Center for Health Care Strategies (CHCS) because some of our members support dual-eligible individuals with disabilities.

As written by CHCS:

“Many states contract with Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) to provide Medicare services to individuals dually eligible for Medicare and Medicaid, but they do not require these D-SNPs to provide coverage of Medicaid long-term services and supports or behavioral health benefits. Starting in 2021, under a recently released rule from the Centers for Medicare & Medicaid Services, these D-SNPs will now be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions.

This brief examines approaches used by three states — Oregon, Pennsylvania, and Tennessee — to develop and implement information-sharing processes for their D-SNPs that support care transitions. It also includes examples of contract language and strategies to encourage plan collaboration around information sharing. It can help states, D-SNPs, and other stakeholders assess how to meet the new D-SNP contracting requirements and improve care for dually eligible individuals.”