Medicaid

This technical assistance tool outlines how states can identify aligned and unaligned enrollees within their dually eligible populations. The first option described in this guide is accessing matching CMS data on Medicare enrollment with state data on Medicaid enrollment. The second option reviewed is collecting aligned enrollment data ddirectly from D-SNPs. This guide includes additional resources states can use to collect more information on identifying Medicare plan enrollment for duals.

This technical assistance tool explains how states can identify Medicaid enrollees who are dually eligible and those who are prospective dual eligibles. The guide outlines how states exchange files with CMS through the Medicare Modernization Act (MMA) file exchange process to identify these individuals. This resource describes how the monthly MMA file exchange process can benefit both states and dually eligible individuals.

This report provides a summary of changes that states have made to their systems for connecting individuals to benefits and explores state agency changes, challenges, and opportunities related to benefits access and enrollment during the COVID-19 crisis. Data and findings are drawn from the ADvancing States 2020 COVID-19 Membership Survey.

This report highlights results from a 50-state GAO survey on what challenges states are experiencing related to federal Medicaid regulations. As part of the survey, GAO conducted interviews with state Medicaid officials to identify the areas of greatest concern. This report identifies four program areas that were rated as significant or moderate challenges to effective program administration. GAO also discusses potential federal actions to address these challenges

This webinar discussed two issue briefs from the MLTSS Institute on aligning Medicare and Medicaid for dually eligible individuals. The briefs covered were, "Starting from Square One: Considerations for States Exploring Medicare-Medicaid" and, “The Value of Integration to State Medicaid Agencies”. The webinar also highlighted the perspective of the District of Columbia, which is planning to launch new program elements to better integrate care.

This brief looks at states who operate Medicare-Medicaid integrated care models based on demonstrations under the federal Financial Alignment Initiative (FAI) or through Dual Eligible Special Needs Plans (D-SNPs) that are aligned with Medicaid managed care plans. It explores factors that contributed to state investment and successful program implementation. The brief also provides an overview of opportunities for other states interested in creating or enhancing integrated care programs.

This report presents highlights from a National Governor's Association Roundtable held in December 2018. At the roundtable, state and federal officials, national experts, and industry and consumer experts discussed challenges and opportunities for states to improve care and manage costs for dual eligibles. Based on the conversation at this event, NGA identifies key considerations for governors and their staff.

This annual report summarizes states’ self-reported data related to certain quality measures, including the timeliness of the PASRR evaluations and the outcomes for applicants and residents resulting from the evaluations. The report also provides a brief background of PASRR and outlines states' data tracking capabilities.

States operating Medicaid waiver programs, as well as other programs, are required to safeguard consumers against critical incidents such as abuse, neglect, exploitation, and unexplained death. While states have different approaches for managing critical incidents; there are key elements that every state should have to better protect its citizens from harm and to reduce the state from liability. This webinar explores key elements related to an effective critical incident management system.

This brief highlights the efforts of states who implemented Value Based Payment initiatives within systems that support individuals with intellectual or developmental disabilities (I/DD). The brief emphasizes the importance of understanding the population and provides an overview of the population served and their length of engagement with the service system. It looks at the experiences of OH and WA in the Medicaid Innovation Accelerator Partnership program from April 2018 to September 2019.