BACKGROUND MATERIALS

 

The following materials provide additional background on Special Needs Plans. These materials were available to conference participants prior to the conference. Please click on the link for that document.

 

Initial Background Materials

• James Verdier & Melanie Au, "Medicare Advantage Special Needs Plans Site Visits." Mathematica Policy Research, Inc., Final Report to the Medicare Payment Advisory Commission, June 2006.

• Christie Provost Peters, "Medicare Advantage SNPs: A New Opportunity for Integrated Care?" National Health Policy Forum, November 11, 2005.

• Karen Tritz, "Integrating Medicare and Medicaid Services Through Managed Care." Congressional Research Service, June 27, 2006.

• Paul Saucier & Brian Burwell, "The Impact of Medicare Special Needs Plans on State Procurement Strategies for Dually Eligible Beneficiaries in Long-Term Care." Thomson Medstat, Final Report to the Centers for Medicare & Medicaid Services, January 2007.

• Alissa Halperin, Patricia Nemore, & Vicki Gottlich, "What’s So Special about Medicare Advantage Special Needs Plans? Assessing Medicare Special Needs Plans for ‘Dual Eligibles.’" Marquette Elder’s Advisor Law Review, Vol. 8(2), Spring 2007.

• Christine Bishop, et al., "Evaluation of Impacts of Medicare Modernization Act Changes on Dual Eligible Beneficiaries in Demonstration and Other Managed Care and Fee-For-Service Settings." Final Report to the Centers for Medicare & Medicaid Services, May 2007.

• Christine Bishop, et al., "Medicare Special Needs Plans: Lessons from Dual-Eligible Demonstrations for CMS, States, Health Plans, and Providers." Report to the Centers for Medicare & Medicaid Services, March 2007.

• Jennifer Podulka, "Medicare Advantage: Special Needs Plans." Medicare Payment Advisory Commission, October 3, 2007.

• Centers for Medicare & Medicaid Services, "Enrollment ‘How To’ Guide for Special Needs Plans (SNPs)." July 19, 2006.

• Centers for Medicare & Medicaid Services, "Quality ‘How To’ Guide for Special Needs Plans (SNPs)." July 19, 2006.

• Centers for Medicare & Medicaid Services, "HPMS: Management Reports – Adhoc Reports." 2005 & 2006 Maps of Special Needs Plans by Type and Number per County, November 2005.

• Centers for Medicare & Medicaid Services, "2008 Call Letter." April 19, 2007.

  Centers for Medicare & Medicaid Services, "Medicare Managed Care Manual." Chapter 1, Sections 10, 20, & 30.2.5.

• Spreadsheet of SNP Enrollment, March 2007. [Microsoft Excel]

Additional Background Materials Suggested By Participants

• Melanie Bella, et al., "Integrated Care Program Design, Rate Setting, and Risk Adjustment: A Checklist for States." Center for Health Care Strategies, Inc., June 2006.

• James M. Verdier, "Medicare Advantage Rate Setting and Risk Adjustment: A Primer for States Considering Contracting with Medicare Advantage Special Needs Plans to Cover Medicaid Benefits." Center for Health Care Strategies, Inc., October 2006.

• Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Section 231, "Specialized MA Plans for Special Needs Individuals."

• Medicare Modernization Act Conference Report, "SNP Report Language." November 2003.

• HR 3162: Children’s Health and Medicare Protection Act of 2007. Section 431, "Extension and Revision of Authority for Special Needs Plans (SNPS)."

• SNP Alliance, "Proposed Enhancements to HR 3162 for Special Needs Plans." September 2007.

• National Health Policy Group, "Integrated SNP Model: A Blueprint for Improving System Performance." Working Document, February 6, 2006.