Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Daim Ntawv Cog Lus thiab Phau Ntawv Qhia Txog Cov Phiaj Xwm Tshwj Xeeb Ob Chav​​ 

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 Cog Lus Xyoo 2027 Phau Ntawv Qhia Txoj Cai​​ 

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.​​ 

*Cov qauv tsis tau qhib ntawm 2026 Network Guidance rau 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​​  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.​​ 

*Cov qauv qhib ntawm 2025 Network Guidance rau EAE D-SNPs Template thiab 2025 D-SNP Medicare Network Template tau raug xa mus rau cov phiaj xwm los 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.​​ 

*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 State Medicaid Agency Contract (SMAC) Boilerplates​​