CMS Medicare-Medicaid Coordination Office (MMCO) January Announcements

The Centers for Medicare & Medicaid Services (CMS), Medicare-Medicaid Coordination Office (MMCO) is pleased to announce the following updates:

• New Resources:
  • Spotlight on the Wisconsin STAR Method: Care Wisconsin’s Approach to Person-Centered Assessment and Care Management for Dually Eligible Beneficiaries
  • Supporting Persons with Co-Occurring I/DD and Behavioral Health Needs: Spotlight on Partners Health Plan New York 
  • Spotlight on CareSource: Identifying Successful Member Engagement Strategies through Rapid-Cycle Improvement
• Reminder: Deadline to Submit Comments on the Draft Manual for State Payment of Medicare Premiums is February 29

New Resource:  Spotlight on the Wisconsin STAR Method: Care Wisconsin’s Approach to Person-Centered Assessment and Care Management for Dually Eligible Beneficiaries

This Spotlight describes a person-centered care management approach called the Wisconsin STAR Method, a simple process that supports care team members in visually mapping out the numerous interacting factors (e.g., physical, social, environmental) that often arise when caring for individuals with complex medical, social, and behavioral health needs, including those who are dually eligible for both Medicare and Medicaid.

Available at: https://www.resourcesforintegratedcare.com/Behavioral_Health/Spotlight/Wisconsin_Star_Method_Person-Centered_Assessment_Care_Management

Intended Audience:  This spotlight is intended for health plans and providers serving dually eligible members with complex care needs.

New Resource:  Supporting Persons with Co-Occurring I/DD and Behavioral Health Needs: Spotlight on Partners Health Plan New York 

This Spotlight describes how PHP, New York’s first and only Medicare-Medicaid plan that exclusively serves individuals with intellectual and developmental disabilities (I/DD), implements a person-centered and integrated approach to care planning and service delivery that begins with a commitment to the whole person.

Available at:  https://www.resourcesforintegratedcare.com/Behavioral_Health_IDD/Spotlight/Partners_Health_Plan

Intended Audience:  This spotlight is intended for providers and health care professionals, front-line staff with health plans and provider practices, and other stakeholders interested in integrated approaches for supporting individuals with co-occurring and complex behavioral and physical health care needs.

New Resource:  Spotlight on CareSource: Identifying Successful Member Engagement Strategies through Rapid-Cycle Improvement

This Spotlight outlines lessons from CareSource’s member engagement pilot program in Ohio to reduce the number of unreached members while connecting these members with case management services.

Available at: https://www.resourcesforintegratedcare.com/Member_Engagement/Spotlight/CareSource_Rapid_Cycle_Improvement

Intended Audience:  This spotlight is intended for providers and health care professionals, front-line staff with health plans and provider practices, and other stakeholders interested in innovative strategies for engaging hard-to-reach members.

Reminder: Deadline to Submit Comments on the Draft Manual for State Payment of Medicare Premiums is February 29

On December 13, 2019, the Centers for Medicare & Medicaid Services (CMS) released a draft Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”) to states and other stakeholders for review and comment. The draft manual updates information and instructions to states on federal policy, operations, and systems concerning the payment of Parts A and B premiums (or buy-in) for individuals dually eligible for Medicare and Medicaid. The manual update is part of CMS’ Better Care for Dual Eligible Individuals Strategic Initiative aimed at improving quality, reducing costs, and improving customer experiences.

States pay Medicare Part B premiums each month for over 10 million individuals and Part A premium for over 700,000 individuals. This process promotes access to Medicare coverage for low-income older adults and people with disabilities, and it helps states ensure that Medicare pays primary to Medicaid for its dually eligible residents. Despite the importance of this process, federal guidance on buy-in is out of date.

For some time, states have sought CMS written direction and guidance on various legislative and regulatory requirements for the payment of Medicare premiums. Through this updated manual, we are aiming to provide current, clear, comprehensive guidance. We hope that you find these updated instructions helpful. We look forward to improving the draft based on your input. 

We are welcoming comments through 5:00 p.m. EST on February 29, 2020. For more information, including instructions on how to submit comments, visit: https://www.cms.gov/index.php/medicare-medicaid-coordination/medicare-medicaid-coordination-office/state-payment-medicare-premiums.