首頁提供者& 合作夥伴雙重特殊需求計劃合約與政策指南​​ 

雙重特殊需求計劃合同和政策指南​​ 

重返雙重合資格受益人的綜合護理​​ 
返回加利福尼亞州的雙重特殊需求計劃​​ 
前往 2026 年合約年度政策指南​​ 

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.​​  

管理式保健部發出了一份All Plan Letter (APL) 23-019 Health Plan Expansion for Medicare Medi-CalPlans，以提供背景資料，並識別受該部監管的保健服務計劃中需要提交 Medi-Medi Plans（EAE D-SNPs 的加州特定名稱）申報的子集。
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合約年度 2026 年度 D-SNP 政策指南​​ 

有關 2026 合約年度政策指南，請造訪即將推出的 D-SNP 政策指南網頁。本版本為截至 9 月的最新版本12,2025 。​​ 

合約年度 2025 年 D-SNP 政策指南​​ 

CalAIM D-SNP 政策指南旨在作為加州所有 D-SNP 的資源，從 2025 合約年開始，提供額外的詳細資訊以補充 2025 SMAC。政策指南》中適用於所有 D-SNP 的條文，以及僅適用於 EAE D-SNP 的條文，會在每一節的開頭註明。本政策指南的規定是 2025 年 DHCS SMAC 要求的一部分。更新將隨著指引的增加而公佈。本版本是截至 2025 年 4 月 16 日的最新版本。請注意，如果您的健康計劃需要最新的 D-SNP 政策指南，請發送電子郵件至 info@CalDuals.org。​​ 

*The unlocked versions of the 2025 Network Guidance for EAE D-SNPs Template and the 2025 D-SNP Medicare Network Template were sent to plans via the info@CalDuals.org inbox on September 6, 2024. For D-SNPs that need the templates to be re-sent, please email info@CalDuals.org.
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合約年度 2024 年度 D-SNP 政策指南​​ 

CalAIM D-SNP 政策指南旨在為加利福尼亞州所有 D-SNP 的資源，從 2024 年合同年開始提供其他詳細信息以補充 2024 SMAC。適用於所有 D-SNP 的政策指南條文，以及僅適用於 EAE d-SNP 的條文，都在每節的開頭列出。本政策指南的條文屬於 2024 年的 DHCS SMAC 要求的一部分。 更新將隨著指導添加時發布。 此版本截至十二月 19，2024 的最新版本。​​ 

* 如果您需要任何模板的解鎖版本，請發送電子郵件 info@CalDuals.org
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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.​​ 

合約年度 2023 年度 D-SNP 政策指南​​ 

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 州醫療補助機構合同（SMAC）標準​​