Dual Eligibles

This study used mystery shoppers in six states to asses the accuracy of PACE awareness in counselors supporting LTSS beneficiaries. This 2018 study focuses on a range of information and referral/assistance entities.

The Financial Alignment Initiative (FAI) is intended to improve the quality of care and reduce spending for low-income people who are dually eligible. Mathematica researchers conducted a study to identify reasons for the varying participation rates across states. This brief explores the details of two major factors: passive enrollment and demonstration/MLTSS alignment.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

This technical assistance tool focuses on the new “information sharing” requirement for Dual Eligible Special Needs Plans beginning in 2021. The tool explains the new requirement as well as how to address the requirement in mandatory D-SNP contracts.

This infographic provides information on coverage and costs for low-income Medicare beneficiaries. The resource describes people on Medicare, financial needs among beneficiaries, programs supporting low-income beneficiaries, and ways to improve access.

The Centers for Medicare & Medicaid Services issued a State Health Official letter that provides guidance on legislative changes to the modified adjusted gross income (MAGI)-based methodologies used for determining Medicaid and CHIP eligibility. In order to implement the changes to MAGI-based methods, states may need to update eligibility policies and procedures and make changes to eligibility systems logic.

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

In 2021, under a recently released rule from CMS, D-SNPs will be required to notify the state or state’s designee when enrollees experience Medicare-covered hospital or skilled nursing facility admissions in order to ensure timely transitions of care. The Integrated Care Resource Center has released a brief that examines approaches from three states – Oregon, Pennsylvania, and Tennessee – to develop and implement information-sharing processes for their D-SNPs that support care transitions.

The GAO released a report to the Chairman of the Committee on Ways and Means summarizing findings of a survey sent to State Health Insurance Assistance Programs (SHIP) directors about the usability of the Medicare Plan Finder (MPF) website. The MPF website is a resource for comparing Medicare coverage options to help beneficiaries make informed decisions about their coverage. The report also includes other areas of improvement to make the website more user-friendly.

CMS has released a notice with information about the process for states to apply for a “good faith effort” (GFE) exemption, which provides up to one year of extra time to come into compliance with Electronic Visit Verification.