Dual Eligibles

NSCLC champions consumer protection for those who have both Medicare and Medicaid (dual eligibles) as several states finalize and implement demonstration plans to move many duals eligible individuals into private managed care plans.

Dual eligibles as a group have higher health needs and lower incomes than other Medicare beneficiaries. They are also more likely to need long term services and supports. Historically, there has been a lack of coordinated care for dual eligibles and the health reform law encouraged state demonstrations to address the problem.

A separate NSCLC website provides aging and disability advocates the information and tools they need to ensure that models for delivering health and long term services and supports to dual eligibles include strong consumer protections. The site houses NSCLC reports, summaries, and comments on state proposals and plans as well as state profiles and federal guidance.

Recent NSCLC activity is highlighted below. Also, NSCLC is educating California advocates in 2013 on that state’s Memorandum of Understanding with the Centers for Medicare and Medicaid Services. Check Events often for related webinars throughout the year.

• Mass. Dual Eligible Contract Analysis Provides Consumer Protection Advice
  September 2013 --As states seek to move thousands of elderly and persons with disabilities with both Medicare and Medicaid (dual eligibles) into private managed care plans, advocates need information on how to address important consumer protections. A ...



• Analysis Compares Appeals Systems in Dual Eligible Demonstration Projects
  NSCLC has published an advocacy tool that compares the design of the appeals systems for the six states that currently have a Memorandum of Understanding (MOU) with the Centers for Medicare and Medicaid Services for dual eligible demonstration projects...



• WEBINAR: The California Coordinated Care Initiative: Advanced I Training – Consumer Protections and Benefit Package Summary
  California is moving forward with the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect. The CCI is now expected to start no sooner than April 1, 2014. This webinar will cover th...



• WEBINAR: Talking to Your Clients about the Duals Demonstrations and MLTSS: Keeping it Simple
  The Aging and Disability Partnership invites you to a webinar: States are gearing up to enroll individuals into new dual eligible and Medicaid managed long term-services and supports (MLTSS) programs. In most states with demonstration projects or ne...



• Revised CCI Advocate’s Guide Released
  Several changes have occurred to the Coordinated Care Initiative (CCI) subsequent to the original release of the Advocate's Guide to California's Coordinated Care Initiative  in July.  The most significant change is that the CCI implementation date i...



• Massachusetts Three-Way Contract: A Summary of Beneficiary Protections
  On July 18, 2013, Massachusetts became the first state to sign a three-way contract for its dual eligible demonstration project. The Medicare-Medicaid Coordination Office in the Centers for Medicare and Medicaid Services published the three-way contrac...



• WEBINAR: Dual Eligible Demonstration Projects Update: Three-Way Contracts, MOUs and Passive Enrollment
  Aug. 28, 2013 - Free Webinar Over the last few months, the Medicare-Medicaid Coordination Office (MMCO) has been busy finalizing contracts with states, providing marketing and enrollment guidance, and creating opportunities for consumer assistance.Â...



• Webinar: The California Coordinated Initiative: An Update on New Rules and Policies
  Over the last few months, many Coordinated Care Initiative (CCI) rules and policies have been created or changed as California moves forward with implementation. This webinar will provide a summary of significant developments related to those rules and...



• Advocate’s Guide on California’s Coordinated Care Initiative
  July 2013 -- The Advocate's Guide to California's Coordinated Care Initiative helps advocates understand the Coordinated Care Initiative (CCI), a new state program changing the way dual eligible beneficiaries and other seniors and persons with disabil...



• Continuity of Care in the Dual Eligible Demonstrations: A Tool for Advocates
  May 2013 -- A key protection for dual eligibles who are enrolling in the financial alignment demonstration projects being undertaken by states and the Medicare-Medicaid Coordination Office (MMCO) is continuity of care.  Individuals joining plans parti...