Dual Eligibles

CMS released a SHO letter with updated guidance to assist states in planning for resuming normal state Medicaid, CHIP, and BHP operations for the eventual end of the public health emergency. The SHO provides updated guidance regarding the extended timeframe for states to complete pending work in eligibility and enrollment to up to 12 months after the PHE ends and redetermination of eligibility requirements states must complete after the PHE for all beneficiaries before taking adverse actions.

This publication from Health Management Associates analyzes the approaches that Medicaid programs in DC, Idaho, Maine, Washington and Alabama used to coordinate Medicare and Medicaid services without standalone Medicaid MLTSS programs. The paper focuses on Medicaid and Aging agencies overseeing programs that provide long-term services and supports fee for service and explores effective methods to coordinate and integrate care with Medicare Advantage Dual Eligible Special Needs Plans.

NCOA has partnered with the Medicare Rights Center to develop a toolkit for counselors who work with dual eligibles and beneficiaries themselves. This toolkit was created following interviews and focus groups with counselors and will be updated continually.

Dual eligibles for Medicare and Medicaid have higher levels of chronic pain and use prescription opioids to treat pain more often than those eligible for Medicare only, putting them at a higher risk for opioid misuse or addiction. This brief presents examples of multimodal pain management options that clinicians can consider for treating pain among dually eligible individuals. The resource describes various treatment options, key evidence, and prescribing considerations for each option.

NCOA has partnered with the Medicare Rights Center to develop a toolkit for counselors who work with dual eligibles and beneficiaries. The toolkit includes a break down of coverage options in an easy-to-understand format for counselors and consumers. This toolkit was created following interviews and focus groups with counselors, and will be updated and enhanced with additional materials on an ongoing basis.

The Social Security Advisory Board has released its annual report summarizing their work during fiscal year 2020 and detailing information regarding its accomplishments, including Board publications and commissioned work.

On March 18, 2021 The Centers for Medicare & Medicaid Services (CMS) released a Medicaid Informational Bulletin with the updated 2021 Federal Poverty Level (FPL) Standards. The bulletin also includes the 2021 Dual Eligible Standards chart that displays the new standards for the Medicare Savings Program categories.

Supported by Arnold Ventures, Mathematica conducted this study to understand what leads dually eligible beneficiaries to remain in, or disenroll from, D-SNPs. They examined the association of MA quality and member experience scores, and level of Medicaid integration, with voluntary disenrollment rates (VDRs) in D-SNP dominant MA contracts. Download the publication to read more.

Resources for Integrated Care (RIC) invites you to explore three new resources related to engaging members in plan governance. These resources are based on feedback from participants in the 2020 Resources for Integrated Care Community of Practice.

In this blog post, ACAP and CHCS share survey results that detail how Community Affiliated Plans (ACAP), including Dual Eligible Special Needs Plan (D-SNP) and Medicare-Medicaid Plans, are addressing existing and new health-related social needs of their dually eligible enrollees during the COVID-19.