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Minnesota’s Demonstration to Integrate Care for Dual Eligibles

The Minnesota Department of Human Services (DHS) and the Centers for Medicare & Medicaid Services (CMS) signed a Memorandum of Understanding (MOU) establishing a “Demonstration to Align Administrative Functions for Improvements in Medicare-Medicaid Beneficiary Experience” within the Minnesota Senior Health Options (MSHO) program. The demonstration is also referred to as the “Dual Demo.”

The Dual Demo began on Sept. 13, 2013, and was scheduled to end Dec. 31, 2016. CMS approved an extension of the demonstration until Dec. 31, 2018, under an extended MOU (PDF). There are no substantial changes to note from the original MOU. The extension by CMS allows for the waivers and objectives to be continued through 2018, which will support continued efforts to improve beneficiary experience in the integrated senior managed care program, MSHO. 

The demonstration is designed to do the following:

  • Enhance integration of services for Medicare-Medicaid beneficiaries through payment reform and new provider payment models with beneficiaries who are dually eligible for both Medicare and Medicaid.
  • Clarify and simplify information and processes about Medicare and Medicaid coverage for beneficiaries and their families.
  • Better align oversight of MSHO plans by the state and CMS.
  • Improve administrative efficiencies for the MSHO plans and government agencies that serve MSHO enrollees.
  • Avoid unnecessary duplication through a joint federal-state monitoring and quality oversight process and a coordinated set of reporting requirements.

The term “dually eligible” refers to people who have benefits through Medicare and Medicaid (known in Minnesota as Medical Assistance). DHS intends to continue discussions with CMS in a second phase of the Dual Demo Project for the Special Needs BasicCare (SNBC) population.

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