This toolkit outlines consumer protections and member rights in D-SNP State Medicaid Agency Contracts, emphasizing continuity of care, accessible appeals processes, and strong safeguards to ensure dually eligible individuals maintain coverage and access to essential services.
This toolkit highlights best practices for member engagement and support in D-SNP State Medicaid Agency Contracts, emphasizing enrollee advisory committees, ombuds programs, and meaningful consumer input to improve access, equity, and quality of care for dually eligible individuals.
This 1-hour webinar covers enrollment rules, care coordination, member protections, and more for Dual Eligible Special Needs Plans (D-SNPs) in California.
Care coordination for people dually eligible is shaped by several overarching federal requirements, including Model of Care requirements, the Home and Community-Based Settings Rule, and the Medicaid Access Rule.
People dually eligible often experience significant confusion during the D-SNP enrollment process, especially regarding the eligibility criteria for enrolling in a D-SNP, whether they may be subject to default enrollment, and what protections are available if they lose D-SNP eligibility.
People are often overwhelmed by the confusing notices they receive about their Medicare and Medicaid coverage. This toolkit helps advocates develop State Medicaid Agency Contract (SMAC) language that requires managed care plans to provide accessible communications for their enrollees.
