NSCLC champions consumer protection for those who have both Medicare and Medicaid (dual eligibles) as several states finalize and implement demonstration plans to move many duals eligible individuals into private managed care plans.
Dual eligibles as a group have higher health needs and lower incomes than other Medicare beneficiaries. They are also more likely to need long term services and supports. Historically, there has been a lack of coordinated care for dual eligibles and the health reform law encouraged state demonstrations to address the problem.
A separate NSCLC website provides aging and disability advocates the information and tools they need to ensure that models for delivering health and long term services and supports to dual eligibles include strong consumer protections. The site houses NSCLC reports, summaries, and comments on state proposals and plans as well as state profiles and federal guidance.
Recent NSCLC activity is highlighted below. Also, NSCLC is educating California advocates in 2013 on that state’s Memorandum of Understanding with the Centers for Medicare and Medicaid Services. Check Events often for related webinars throughout the year.
- Continuity of Care in the Dual Eligible Demonstrations: A Tool for Advocates
A key protection for dual eligibles who are enrolling in the financial alignment demonstration projects being undertaken by states and the Medicare-Medicaid Coordination Office (MMCO) is continuity of care. Individuals joining plans participating in ...
- Forty One California Organizations Express Concerns about Cal Medi-Connect
(5/2/13) On behalf of the state’s dual eligibles, advocates call for limiting the demonstration size, a more realistic implementation timeframe, voluntary enrollment, requiring home and community-based services as part of benefit package, and more.
- Summary of California Dual Eligible Agreement with CMS
On March 27th, the Centers for Medicare and Medicaid Services (CMS) entered into a Memorandum of Understanding (MOU) with the California Department of Health Care Services (DHCS) to implement a dual eligible demonstration that will transform the way Me...
- Summary of Illinois Dual Eligible Agreement with CMS
On February 22, 2013 the Centers for Medicare and Medicaid Services (CMS) entered into a Memorandum of Understanding with the State of Illinois approving the Illinois Medicare-Medicaid Alignment Initiative. Illinois is the fourth state to execute a MO...
- How Dual Eligibles Can Benefit from Medicaid PCP Payment Increases
In this report, NSCLC analyzes the specific impact of a new rule that means state Medicaid program are required to pay certain physicians at rates that are no lower than Medicare's.
- Summary of Ohio Dual Eligible Demonstration Agreement
NSCLC summaries the Memorandum of Understanding between the state of Ohio and the federal Centers for Medicare and Medicaid Services.
- Summary of Mass. Dual Eligible Demonstration Agreement
A summary of the first Memorandum of Understanding for a dual eligible demonstration project with the federal Centers for Medicare and Medicaid Services.
- Summary of Washington Dual Eligible Demonstration Agreement
NSCLC summarizes the Memorandum of Understanding between the state of Washington and the federal Centers for Medicare and Medicaid Services.
- Over 100 Ask MMCO for Ombudsman in Duals Demonstration Projects
An impressive list of 103 organizations joined a sign-on letter that NSCLC and the National Committee to Preserve Social Security and Medicare drafted that urges the Medicare Medicaid Coordinated Office at the Centers for Medicare and Medicaid services...
- CMS Approves New York Transfer of Medicaid LTSS into Managed Care
On August 31, 2012, the Center for Medicare and Medicaid Services (CMS) agreed to amend both of its managed care demonstrations to include long-term services and supports (LTSS) on a mandatory basis. As part of the approval, CMS amended the Special T...