A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Final Duals Proposal Submitted to CMS – Round Two of Comments

Final Duals Proposal Submitted to CMS – Round Two of Comments

February 27, 2012

Last Friday, the Center for Medicare and Medicaid Services (CMS) posted the state’s final Duals Demonstration proposal. The proposal would set up a fully integrated care program for people with disabilities under age 65 who are covered by both Medicaid and Medicare. Here's how the proposal's introduction frames the issue:

Dual eligible individuals under age 65 have among the most complex care needs of any MassHealth or Medicare members, yet the current delivery system for this population strains, unevenly and inefficiently, to meet those needs. The Demonstration will provide comprehensive services that address members’ full
range of needs, beyond currently covered standard Medicare and Medicaid benefits. It will ensure that the services are effective by delivering them in a setting of integrated care management and coordination within a primary care centered model. And the Demonstration will employ a payment structure that realigns the conflicting incentives between Medicare and Medicaid.

Following the release of the draft proposal in December, MassHealth held a 30-day comment period, during which it held two public listening sessions and collected written comments from dually eligible members, community organizations, providers and health plans. In response to substantial public input, MassHealth incorporated a number of changes into the final proposal.

CMS is now seeking public input through a 30-day comment period. We strongly encourage all interested individuals or groups to submit comments to help inform CMS’s review of the proposal. Comments are due by 5 pm on March 19 and should be submitted to MedicareMedicaidCoordination@cms.hhs.gov.

Pending approval of the state’s proposal, MassHealth is seeking continued public input on implementation topics and will hold the next Open Meeting with stakeholders as follows:

February 28, 2012, 3:00-5:00 PM
1 Ashburton Place, 21st Floor
Boston, MA 02108

Stay tuned for more information on the duals initiative.

-Kaitlyn Rhodes