State Technical Assistance Opportunities
The Integrated Care Resource Center (ICRC) offers technical assistance to help states
improve the coordination of care for Medicare-Medicaid beneficiaries through the
development of new integrated care programs. Technical assistance is available to
states at all levels of readiness.
In addition to one-on-one state technical assistance, the ICRC coordinates the following
collaborative learning call series for states that are in the design or implementation
phase of Medicare-Medicaid integration activities:
Medicare-Medicaid Integration Study Hall Call Series This virtual
learning opportunity is for states preparing to implement either capitated or managed
fee-for-service Medicare-Medicaid financial alignment models. Topics have included
enrollment, program monitoring, member outreach, readiness reviews, and provider
network development. Any state pursuing an integrated model for Medicare-Medicaid
enrollees may participate. For more information, contact Michelle Soper, Center
for Health Care Strategies, at email@example.com.
Medicare 101 and 201: Issues for States (Integrated Care Resource Center/January
2015) This presentation covers Medicare program basics, including: (1) Medicare-Medicaid
enrollee characteristics; (2) Medicare eligibility pathways; (3) an overview of
Medicare managed care and state contracting with Medicare Advantage Dual Eligible
Special Needs Plans (D-SNPs); (4) overlapping benefits and other Medicare coverage
issues; and (5) Medicare policy updates, key dates, and resources relevant for state
- Building and Validating
LTSS Provider Networks (Integrated Care Resource Center/January 2015)
This presentation examines strategies for states establishing Medicaid managed long-term
services and supports (MLTSS) or integrated care programs to ensure that health
plans develop LTSS provider networks to address beneficiaries’ diverse needs.
Processing and Technical Assistance for Medicare-Medicaid Demonstration States
(Integrated Care Resource Center/December 2014) This presentation reviews the
steps in the Medicare-Medicaid Plan (MMP) enrollment process for states participating
in capitated model financial alignment demonstrations and highlights lessons about
the enrollment process from states that began enrollment in 2013 and 2014. Recording.
- Engaging Providers
in Integrated Care Programs (November 2014) This presentation highlighted
tips for engaging providers throughout the design and implementation of integrated
care programs; described Virginia’s approach to provider engagement for its financial
alignment demonstration; and included an overview of Independent Care Health Plan’s
(iCare) approach to building provider relationships.
with Medicare: Introduction to State Contracting with D-SNPs (November
2014) This presentation provided an overview of states contracts with Dual Eligible
Special Needs Plans (D-SNPs) and how states can advance integration through D-SNP
Marketing Rules and Practices for Medicare and Medicaid Managed Care
(October 2014) In this presentation, an ICRC speaker provided an overview of the
major differences between Medicare and Medicaid marketing requirements and opportunities
for better alignment, and a speaker from MassHealth offered lessons learned from
the roll out of Massachusetts’ integrated marketing process.
Direction in Integrated Care Programs (Integrated Care Resource Center/July
2014) In this presentation, a representative of the National Resource Center for
Participant-Directed Services gave a brief overview of participant direction and
provided findings from a recent review of contract language while speakers from
Massachusetts' Commonwealth Care Alliance health plan described how the plan supports
members who wish to self-direct services.
Medicare Advantage D-SNP Contract Oversight and Quality Monitoring
(May 2014) This document summarizes a telephone discussion among states, the Centers
for Medicare & Medicaid Services, the National Association of Medicaid Directors,
and ICRC about Medicare Advantage (MA) Dual Eligible Special Needs Plan (D-SNP)
contract oversight and quality monitoring procedures.
Update on Evaluations of Financial Alignment Demonstrations: Part 1
(April 2014) RTI staff gave a detailed description of the initial steps in the evaluation
of state demonstrations under the Financial Alignment Initiative, including: (1)
receipt of an introduction letter with state-specific evaluation team members’ names
and contact information; (2) use of the State Data Reporting System; and (3) use
of the “finder file” for the evaluation.
Advantage Enrollment Processes: D-SNP New Entries, Service Area Changes, Terminations,
Non-Renewals, and Seamless Conversions (March 2014) This document summarizes
a telephone discussion among states, the Centers for Medicare & Medicaid Services,
the National Association of Medicaid Directors, and ICRC regarding Medicare Advantage
Dual Eligible Special Needs Plans (D-SNPs) non-renewals, service area changes, terminations,
new entries, seamless conversions, and passive enrollment.
Denial Notice (November 2013) CMS provided background on the integrated
denial notice and discussed the applicability of the integrated denial notice outside
of the financial alignment demonstrations, using New York as an example.
Marketing and Member Materials (July 2013) CMS provided an overview
of demonstration marketing principles, CMS marketing guidance, and marketing surveillance
activities for states participating in the capitated Financial Alignment Demonstration.
State staff from MassHealth’s One Care program described Massachusetts’ experiences
in marketing its program.
Guidance (June 2013) CMS described the process for beneficiary enrollment
in Medicare-Medicaid Plans. The accompanying reference guide describes the process
that states and health plans participating in the capitated Financial Alignment
Demonstration will use to submit information to CMS’ MARx systems.
The Three Way Contract (May 2013) CMS provided an overview of the three
way contract organization, discussed the interplay between the contract and other
demonstration documents, and described the contract development and review processes.
Integrated Appeals & Grievances (April 2013) CMS provided an overview
of the Medicare appeals process and gave examples of the integrated Medicare/Medicaid
appeals processes in proposed for the demonstrations in California, Massachusetts,
Ohio, and New York.
Consumer Direction in Managed Long-Term Services and Supports Programs
(March 2013) The National Resource Center for Participant-directed Services explained
participant direction and how it can be included in contract language, then staff
from the Arizona Health Care Cost Containment System gave an example of how Arizona
implemented consumer direction in its long-term care system (ALTCS).
Training Strategies and Lessons Learned (August 2012) Discussed the
training strategies and lessons learned from the implementation of Tennessee’s Medicaid
managed long-term services and supports program.