CMS Launches Initiatives to Improve Care, Lower Costs for Dual Eligibles - May 17, 2011

The federal Centers for Medicare & Medicaid Services (CMS) on May 11 announced a series of initiatives aimed at helping state Medicaid programs save money and improve care for those individuals enrolled in both Medicare and Medicaid, also known as dual eligibles. First, CMS announced the launch of the Alignment Initiative, a program that will help integrate benefits under Medicare and Medicaid to improve quality and reduce costs for the treatment of dual eligibles. As part of the Alignment Initiative, CMS issued a request for information for input on opportunities to effectively align Medicare and Medicaid benefits. CMS is requesting feedback in six areas: coordinated care, fee-for-service benefits, prescription drugs, cost sharing, enrollment and appeals. Comments are due July 11. In addition to the Alignment Initiative, CMS issued an informational bulletin reminding states they may request timely claims/event data for Medicare Parts A, B and D, in order to support dual-eligible care coordination. As part of the bulletin, CMS also announced it will provide states with more timely “non-final action” Medicare Part D Prescription Drug Event data, as opposed to the “final action” data previously available. More information on the process for requesting specific Medicare claims/event and eligibility/enrollment data, is available online.