Dual Eligibles

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Biden-Harris Administration Requires Insurance Companies and Group Health Plans to Cover the Cost of At-Home COVID-19 Tests

As part of its ongoing efforts across many channels to expand Americans’ access to free testing, the Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of over-the-counter, at-home COVID-19 tests, so people with private health coverage can get them for free starting January 15, 2022.

Short URL: http://www.advancingstates.org/node/73327

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Integrated Care for People with Medicare and Medicaid

NCOA, in partnership with the Medicare Rights Center, recently expanded the resources in their toolkit that help explain integrated care coverage options for dual eligibles. New items in the toolkit include a video tutorial explaining integrated care, an infographic for counselors, and comparison charts highlighting the differences between Original Medicare, PACE, Duals Special Needs Plans (D-SNPs) and integrated D-SNPs.

Short URL: http://www.advancingstates.org/node/73204

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State Health Official Letter - Updated Guidance Related to Planning for the Resumption of Normal State Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health Emergency

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.

Short URL: http://www.advancingstates.org/node/72973

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State Efforts to Integrate Care Across Medicaid Fee-for-Service Long-Term Services and Supports and Medicare Advantage Dual Eligible Special Needs Plans

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.

Short URL: http://www.advancingstates.org/node/72773

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File Downloads / Links

Multimodal Pain Management: Considerations for Clinicians Treating Pain

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.

Short URL: http://www.advancingstates.org/node/72631

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Integrated Care Toolkit for People with Medicare and Medicaid

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.

Short URL: http://www.advancingstates.org/node/72543

File Downloads / Links

File Downloads / Links

Informational Bulletin: 2021 Federal Poverty Level Standards

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.

Short URL: http://www.advancingstates.org/node/72463

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