Health Affairs February 23, 2024
The Centers for Medicare and Medicaid Services (CMS) recently proposed several regulations aimed at reforming the Medicare Advantage (MA) program and the Medicare Prescription Drug Benefit (Part D) program. A key objective of these proposed regulations is to increase the number of dual-eligible Medicare and Medicaid beneficiaries (dual eligibles) in financially integrated care models and to further address threats to integrated care in the form of Dual-Eligible Special Needs Plan (D-SNP) “look-alike plans”—that is, conventional MA plans that primarily enroll dual eligibles but are not subject to federal regulations for integrating Medicaid services.
This article discusses the proposed regulations, specifically as they relate to increasing opportunities for dual eligibles to enroll in integrated care plans, reducing “choice overload” for dual...
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