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States and the federal government should ensure that MCOs (including those participating in duals demonstrations) seek to improve the quality and value of care for dual-eligibles.
States, in partnership with the federal government, must have sufficient capacity to monitor MCO compliance effectively and take corrective action where necessary.
Federal and state governments must ensure that all models of care designed to enhance beneficiary experience, improve quality, reduce unnecessary service use, and lower costs for duals (including f
Federal and state governments should ensure the care that dual-eligibles receive through MCOs and other delivery models is coordinated and delivered in a person- and family-centered manner.
Both levels of government should ensure that efforts to harmonize Medicare and Medicaid preserve beneficiary access to each program’s most protective benefit and due process policies.
Federal and state governments should collaborate to develop, execute, and continually evaluate a coordinated Medicare-Medicaid grievance and appeals process for dual-eligibles.
State and federal policymakers should ensure that the duals demonstrations designed to test the integration of Medicare and Medicaid services (including the provision of LTSS) are reasonably limite