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: Jan 31, 2024
Publisher: Integrated Care Resource Center
To operate in a state, a Dual Eligible Special Needs Plan (D-SNP) must hold a contract with the state Medicaid agency. Those state Medicaid agency contracts (SMACs) must all have at least certain minimum elements, and states can also add additional requirements that aim to further coordination or integration of Medicare and Medicaid benefits for D-SNP enrollees. These technical assistance tools for states provide sample contract language for the minimum required SMAC elements, as well as optional elements that states can add to SMACs with D-SNPs to further state goals related to care coordination, D-SNP enrollment, reporting and information sharing, and D-SNP materials.

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