Although independent
evaluations of ongoing demonstrations to integrate care for dual-eligible
Medicare-Medicaid beneficiaries are still underway, an April 24 letter from CMS
Administrator Seema Verma signaled the agency's commitment to proving the value
of the models as well as testing alternatives.
In the letter to state
Medicaid directors, CMS extended three new opportunities to "test
state-driven approaches" for integrating duals' care:
(1) For interested states
with capitated Financial Alignment Initiative (FAI) model demos, CMS said it is
"open to partnering on revisions."
(2) For interested states
without capitated demos, CMS said it welcomes interest in testing the model
through new demos in additional states.
(3) CMS said it is open
to partnering with states on testing new state-developed models to better serve
dual eligibles and invited states to respond with ideas, concept papers and/or
proposals.
Kevin Malone, a senior
counsel in the Health Care and Life Sciences practice in the Washington, D.C.,
office of Epstein Becker & Green, P.C. and a former duals officer at CMS,
predicts that, for states with existing demos, they will not only revisit their
memoranda of understanding that outline the terms of their agreements with CMS,
but will use it as a chance to amend their three-way contracts with CMS and
plans. This presents a unique opportunity for the plans to suggest changes
around certain programmatic requirements or provider training that may reduce
some of their burden and streamline some of the technical details of their
arrangements.
From RADAR on Medicare Advantage
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