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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.
States should ensure that all care and services provided to dual-eligibles through MCOs address their individual health care and LTSS needs and preferences (including a self-directed care option fo
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
States should use a portion of any savings from the duals demonstrations to strengthen and improve access to and availability of community-based LTSS.
States and the federal government should ensure that managed FFS delivery models provide care coordination services to vulnerable dual-eligibles.
MSPs should be fully funded to ensure all eligible individuals have financial access to benefits.