Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans

Sample Language for State Medicaid Agency Contracts with Dual Eligible Special Needs Plans

Published: May 30, 2020
Publisher: Integrated Care Resource Center
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Associated Project

Supporting States in Improving Care for Dually Eligible Individuals through the Integrated Care Resource Center

Time frame: 2011-2024

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office

Authors

This Integrated Care Resource Center technical assistance tool provides sample contract language that states can leverage in executing federally required state Medicaid agency contracts (SMACs) with Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs). The tool provides sample language for federal minimum requirements for all D-SNPs, as well as sample language for requirements that only apply to fully or highly integrated D-SNPs (FIDE SNPs and HIDE SNPs, respectively).

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