Dual Special Needs Plans Contract and Policy Guide
Rov qab mus rau Integrated Care rau Dual Tsim Nyog tau txais txiaj ntsig
Rov qab mus rau Dual Special Needs Plans hauv California
Mus rau Daim Ntawv Qhia Txog Txoj Cai Xyoo 2027
Dual Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal, and offer care coordination and wrap-around services. All D-SNPs in California must have executed contracts with the Department of Health Care Services (DHCS), the state Medicaid agency. These contracts, referred to as the “State Medicaid Agency Contract” (SMAC) or MIPPA contract, must meet a number of requirements, including Medicare-Medicaid integration requirements. DHCS maintains the authority to contract or not to contract with D-SNPs.
Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob tau tshaj tawm tsab ntawv All Plan Letter (APL) 23-019 Kev Nthuav Dav ntawm Kev Npaj Kho Mob rau Medicare Medi-Cal Plans los muab keeb kwm yav dhau los thiab txheeb xyuas cov pawg me me ntawm cov phiaj xwm kev pabcuam kho mob uas Lub Tsev Haujlwm tswj hwm uas yuav tsum xa daim ntawv thov rau Medi-Medi Plans, cov npe tshwj xeeb hauv California rau EAE D-SNPs.
Daim Ntawv Cog Lus Xyoo 2026 D-SNP Txoj Cai Qhia
Phau Ntawv Qhia Txog Txoj Cai CalAIM D-SNP yog tsim los ua ib qho chaw pab rau txhua tus D-SNPs hauv California, pib txij xyoo cog lus 2026, los ntawm kev muab cov ntsiab lus ntxiv los ntxiv rau 2026 SMAC. Cov kev cai ntawm Phau Ntawv Qhia Txoj Cai uas siv rau txhua D-SNPs, thiab cov uas siv rau EAE D-SNPs xwb, tau qhia nyob rau thaum pib ntawm txhua ntu. Cov kev cai ntawm Phau Ntawv Qhia Txoj Cai no yog ib feem ntawm DHCS SMAC cov kev cai rau xyoo 2026. Cov kev hloov tshiab yuav raug tshaj tawm thaum muaj kev qhia ntxiv. Tsab ntawv no yog tam sim no txij li Lub Ob Hlis 27, 2026 . Nco ntsoov, yog tias koj txoj kev npaj kho mob xav tau Phau Ntawv Qhia Txoj Cai D-SNP tshiab tshaj plaws, thov xa email rau info@CalDuals.org.
D-SNP Txoj Cai Phau Ntawv Qhia (2026)
Cov Ntaub Ntawv Ntxiv
2026 Cov Lus Qhia Txog Kev Sib Txuas Lus rau EAE D-SNPs Taxonomy Crosswalk
*Cov qauv qhib ntawm 2026 Network Guidance for EAE D-SNPs Template thiab 2026 D-SNP Medicare Network Template tau raug xa mus rau cov phiaj xwm ntawm info@CalDuals.org lub thawv xa ntawv rau lub Cuaj Hlis 12, 2025. Rau D-SNPs uas xav tau cov qauv rov xa dua, thov email rau info@CalDuals.org.
Daim Ntawv Cog Lus Xyoo 2025 D-SNP Txoj Cai Qhia
Phau Ntawv Qhia Txoj Cai CalAIM D-SNP yog npaj los ua cov peev txheej rau txhua tus D-SNPs hauv California, pib xyoo ntawv cog lus 2025, los ntawm kev muab cov ntsiab lus ntxiv los ntxiv rau 2025 SMAC. Txoj Cai Qhia Txoj Cai uas siv rau tag nrho D-SNPs, thiab cov uas siv rau EAE D-SNPs nkaus xwb, tau qhia nyob rau hauv qhov pib ntawm txhua ntu. Cov kev cai ntawm Phau Ntawv Qhia Txoj Cai no yog ib feem ntawm DHCS SMAC cov cai rau xyoo 2025. Kev hloov tshiab yuav raug tshaj tawm raws li kev taw qhia ntxiv. Tsab ntawv no yog tam sim no txij lub Plaub Hlis 16, 2025. Nco tseg, yog tias koj txoj kev npaj khomob xav tau D-SNP Txoj Cai Qhia Txog tam sim no, thov email info@CalDuals.org.
D-SNP Txoj Cai Qhia Txog (2025)
Cov Ntaub Ntawv Ntxiv
2025 Cov Lus Qhia Txog Kev Sib Txuas Lus rau EAE D-SNPs - Kev Sib Txuas Lus Txog Kev Txheeb Xyuas (Lub Ib Hlis Ntuj xyoo 2024)
*Cov qauv qhib ntawm 2025 Network Guidance for EAE D-SNPs Template thiab 2025 D-SNP Medicare Network Template tau raug xa mus rau cov phiaj xwm ntawm info@CalDuals.org inbox rau lub Cuaj Hlis 6, 2024. Rau D-SNPs uas xav tau cov qauv rov xa dua, thov email rau info@CalDuals.org.
Daim Ntawv Cog Lus Xyoo 2024 D-SNP Txoj Cai Qhia
Phau Ntawv Qhia Txoj Cai CalAIM D-SNP yog npaj los ua cov peev txheej rau txhua tus D-SNPs hauv California, pib xyoo ntawv cog lus 2024, los ntawm kev muab cov ntsiab lus ntxiv los ntxiv rau 2024 SMAC. Txoj Cai Qhia Txoj Cai uas siv rau tag nrho D-SNPs, thiab cov uas siv rau EAE D-SNPs nkaus xwb, tau qhia nyob rau hauv qhov pib ntawm txhua ntu. Cov kev cai ntawm Phau Ntawv Qhia Txoj Cai no yog ib feem ntawm DHCS SMAC cov cai rau xyoo 2024. Kev hloov tshiab yuav raug tshaj tawm raws li kev taw qhia ntxiv. Tsab ntawv no yog tam sim no txij lub Kaum Ob Hlis 19, 2024.
D-SNP Txoj Cai Phau Ntawv Qhia (2024)
Cov Ntaub Ntawv Ntxiv
2024 Cov Lus Qhia Txog Kev Sib Txuas Lus rau EAE D-SNPs - Qauv 11.28.2023
Xyoo 2024 Cov Lus Qhia Txog Kev Sib Txuas Lus rau EAE D-SNPs - Kev Sib Txuas Lus Txog Kev Cai (Lub Ib Hlis Ntuj xyoo 2023)
Xyoo 2024 D-SNP Medicare Network - Daim Qauv 11.23.2023
Kev Tshaj Tawm Txog Qhov Zoo thiab Cov Ntaub Ntawv ntawm D-SNP
*Yog tias koj xav tau ib qho version uas tsis tau qhib rau txhua tus qauv, thov xa email rau info@CalDuals.org
For Contract Year 2024, DHCS will use the SMAC to require that all D-SNPs in California with EAE: (a) establish Medicare Advantage (MA) contracts (H contracts) that only include one or more D-SNPs within the state; and (b) integrate certain materials and notices for members. Please note that D-SNPs with EAE includes the state’s Fully Integrated D-SNP, effective January 1, 2024. DHCS also notes that MA organizations implementing this policy should also include their non-EAE D-SNPs in the same H contract as their EAE D-SNP.
Daim Ntawv Cog Lus Xyoo 2023 D-SNP Txoj Cai Qhia
The CalAIM D-SNP Policy Guide is intended to serve as a resource for all D-SNPs in California, beginning in contract year 2023, by providing additional details to supplement the 2023 SMAC. The Policy Guide provisions that apply to all D-SNPs, and those that apply only to EAE D-SNPs, are indicated at the beginning of each section. The provisions of this Policy Guide will be part of the DHCS SMAC requirements for 2023. Updates will be published as guidance is added. This latest edition is current as of November 17, 2023.
D-SNP Txoj Cai Qhia Txog (2023)
Cov Lus Cim
Cov Lus Qhia AEVS
Cov Lus Qhia Txog Kev Sib Txuas Lus{
Cov Ntaub Ntawv Ntxiv
2023 Cov Lus Qhia Txog Kev Sib Txuas Lus Hauv Is Taws Nem rau EAE D-SNPs - Kev Sib Txuas Lus Txog Kev Cai (Lub Peb Hlis Ntuj 2022)
2023 Cov Lus Qhia Txog Kev Sib Txuas Lus Hauv Is Taws Nem rau EAE D-SNPs - Qauv 3.6.2023
Xyoo 2023 Kev Thov Rov Qab thiab Kev Tsis Txaus Siab Ua Ke - Cov Lus Qhia Sib Piv Qhov Yuav Tsum Tau Ua
D-SNP Kev Tshaj Tawm Zoo thiab Cov Ntaub Ntawv
D-SNP Cov Cai Tswjfwm Kev Kho Mob Palliative
D-SNP State Medicaid Agency Contract (SMAC) Boilerplates
Xyoo 2026 Boilerplate EAE
2026 Boilerplate Tsis yog EAE
Xyoo 2025 Boilerplate EAE
2025 Boilerplate Tsis-EAE
Xyoo 2024 Boilerplate EAE
2024 Boilerplate Tsis-EAE
Muab tso rau hauv H
Xyoo 2023 Boilerplate EAE
2023 Boilerplate Tsis-EAE
2022 Boilerplate CCI Tsis-CMC
2022 Boilerplate CCI-CMC
2022 Boilerplate Tsis-CCI
D-SNP State Medicaid Agency Contract Boilerplate, Non-CCI County – Contract Year 2021
D-SNP State Medicaid Agency Contract Boilerplate, CCI County – Contract Year 2021