The Centers for Medicare and Medicaid Services and Minnesota to Conduct Demonstration for Dual Eligibles

The Centers for Medicare and Medicaid Services (CMS) and Minnesota have successfully negotiated a memorandum of understanding (MOU) to move ahead with a demonstration to integrate and coordinate health care for individuals who are eligible for both Medicare and Medicaid. Minnesota will use a program that has been in place since 1997, Minnesota Senior Health Option (MSHO). Under the program, health plans, which operate as Dual Eligible Special Needs Plans (D-SNPS), will continue to provide integrated care for members and provide information to them about all of the benefits available in a more integrated manner. The MSHOs will use integrated grievance and appeals processes. Minnesota’s demonstration is different from the previous seven that CMS has approved in that it is neither a managed fee-for-services model, such as Washington State, nor a capitated model, such as Massachusetts, Illinois, California, Ohio, Virginia, and New York. Minnesota’s demonstration is a set of administrative improvements designed to simplify the process of obtaining benefits under Medicare and Medicaid for beneficiaries.

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