Dual-eligible future cloudy

The National Association of Medicaid Directors is asking for more guidance on the dual-eligible program and for regulators to “articulate next steps for existing financial alignment demonstrations.”

The Dec. 1 letter to the Centers for Medicare & Medicaid Services came after some providers had been accused of trying to persuade people to opt out of a managed care demonstration project due to potential lower pay rates. 

Five states are conducting the demonstrations, in which people who are eligible for both Medicare and Medicaid can have their benefits administered through a managed care plan. The theory is that this will lead to more coordinated, cost-efficient care. 

“We believe federal policymakers must begin to engage with states to plan for the next steps for demonstrations,” the association's letter states. “States are eager to understand CMS' long-range work plan for the demonstrations, including whether these will continue during the CMS evaluation period.”

NAMD officials are asking CMS for two assurances: minimizing enrollee disruptions for future transitions and “significant advance notice” to allow for continuity of care planning.

Lacking clear answers from federal officials, NAMD stated, “we believe we must continue to forge ahead with innovations that will improve the quality and coordination of services for this most vulnerable population.”