2020 Outlook: SNPs Look to States, CMS for Direction on Duals Integration

Jan 04
Jan 04, 2020

For Medicare Advantage Special Needs Plans (SNPs) and other insurers serving individuals who are eligible for both Medicare and Medicaid, 2020 “will be the year of building momentum for integration of dual eligibles,” declares Cheryl Phillips, M.D., president and CEO of the SNP Alliance.

More than 3.1 million MA beneficiaries are currently enrolled in a SNP, including nearly 2.7 million individuals served by a Dual Eligible SNP (D-SNP). The plans, which can also take the form of Chronic Condition SNPs (C-SNPs) or Institutional SNPs (I-SNPs), were authorized under the Medicare Modernization Act of 2003 and went through a series of brief reauthorizations until the Bipartisan Budget Act of 2018 granted them permanent authorization. That legislation called for D-SNPs and states to better unify appeals and grievances processes across the Medicare and Medicaid programs and set new minimum standards for D-SNPs integrating Medicaid benefits.
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.