duals

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Becoming a Medicare Fee-For-Service Provider: What CBOs Need to Know

This guide highlights the benefits and opportunities available for CBOs interested in providing services under Medicare FFS. It describes important considerations including billing and filing processes, culture change, and regulatory compliance. The guide also reviews how to enroll as a Medicare provider and outlines which services CBOs can offer.

Short URL: http://www.advancingstates.org/node/72132

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Using Medicare Modernization Act (MMA) Files to Identify Dually Eligible Individuals

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.

Short URL: http://www.advancingstates.org/node/72113

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MACPAC June 2020 Report to Congress on Medicaid and CHIP

The MACPAC June 2020 Report to Congress on Medicaid and CHIP was created prior to the COVID-19 pandemic and highlights long-term challenges facing Medicaid. Across six chapters, it discusses key issues including integrated care for dually eligible Medicaid and Medicare beneficiaries, Medicare Savings Programs, and Medicaid's statutory role as the payer of last resort.

Short URL: http://www.advancingstates.org/node/72049

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Enticing Dually Eligible Beneficiaries to Enroll in Integrated Care Plans

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.

Short URL: http://www.advancingstates.org/node/71771

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Promoting Information Sharing by Dual Eligible Special Needs Plans to Improve Care Transitions: State Options and Considerations

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.

Short URL: http://www.advancingstates.org/node/71656

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Report for Washington Health Home Managed Fee-for-Service (MFFS): Final Demonstration Year 2 and Preliminary Demonstration Year 3 Medicare Savings Estimates

This report summarizes the Medicare Parts A & B actuarial savings analysis of the Washington managed fee-for-service (MFFS) demonstration for 2015 and 2016. The Washington Health Home MFFS demonstration aims to improve service quality and integration while reducing costs of care for high-risk, high-cost dually eligible beneficiaries. For 2015, Washington demonstrated a final gross Medicare savings of $30 million. The preliminary gross Medicare savings for 2016 are $42 million.

Short URL: http://www.advancingstates.org/node/70922

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