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Information and Guidance for Plans

SPOTLIGHT & RELEASES

04/11/2019 - (MMP Application & Annual Requirements page)

CY 2020 Medication Therapy Management Program Guidance and Submission Instructions (04/05/2019)

04/10/2019 - (MMP Application & Annual Requirements page)

CY 2020 Submission of Plan Benefit Packages Memorandum (04/08/2019)

04/04/2019 - (MMP Quality Withhold Methodology & Technical Notes page)

Quality Withhold Adjustment for Extreme and Uncontrollable Circumstances (04/01/2019)

04/03/2019 - (MMP Application & Annual Requirements page)

Applicability of CY 2020 Final Call Letter Provisions to MMPs (04/02/2019) 

CY 2020 Medicare Advantage Capitation Rates & Part D Payment Policies Final Call Letter (04/01/2019)

03/21/2019 - (MMP Reporting Requirements page)

California-Specific Reporting Update Memo (02/28/2019) 

California-Specific Reporting Requirements (02/28/2019) 

California-Specific Value Sets Workbook (02/28/2019) 

Illinois-Specific Reporting Update Memo (02/28/2019) 

Illinois-Specific Reporting Requirements (02/28/2019) 

Illinois-Specific Value Sets Workbook (02/28/2019) 

Massachusetts-Specific Reporting Update Memo (02/28/2019) 

Massachusetts-Specific Reporting Requirements (02/28/2019) 

Massachusetts-Specific Value Sets Workbook (02/28/2019) 

Michigan-Specific Reporting Update Memo (02/28/2019) 

Michigan-Specific Reporting Requirements (02/28/2019) 

Michigan-Specific Value Sets Workbook (02/28/2019) 

New York FIDA-Specific Reporting Update Memo (02/28/2019) 

New York FIDA-Specific Reporting Requirements (02/28/2019) 

New York FIDA-Specific Value Sets Workbook (02/28/2019) 

New York FIDA-IDD-Specific Reporting Update Memo (02/28/2019) 

New York FIDA-IDD-Specific Reporting Requirements (02/28/2019) 

New York FIDA-IDD-Specific Value Sets Workbook (02/28/2019) 

Ohio-Specific Reporting Update Memo (02/28/2019) 

Ohio-Specific Reporting Requirements (02/28/2019) 

Ohio-Specific Value Sets Workbook (02/28/2019) 

Rhode Island-Specific Reporting Update Memo (02/28/2019) 

Rhode Island-Specific Reporting Requirements (02/28/2019) 

Rhode Island-Specific Value Sets Workbook (02/28/2019) 

South Carolina-Specific Reporting Update Memo (02/28/2019) 

South Carolina-Specific Reporting Requirements (02/28/2019) 

South Carolina-Specific Value Sets Workbook (02/28/2019) 

Texas-Specific Reporting Update Memo (02/28/2019) 

Texas-Specific Reporting Requirements (02/28/2019) 

Texas-Specific Value Sets Workbook (02/28/2019)

03/19/2019 Revised (MMP Reporting Requirements page)

Core Measure 2.1 Frequently Asked Questions (FAQs) (03/14/2019)

Core Measure 3.2 Frequently Asked Questions (FAQs) (03/14/2019)


Overview

This page includes information and guidance for Medicare-Medicaid Plans (MMPs) participating in the Financial Alignment Initiative capitated model demonstrations and the Minnesota Demonstration to Integrate Care for Dual Eligibles in the following areas:

  • Application & Annual Requirements
  • Reporting Requirements
  • Audit Programs
  • Enrollment
  • Encounter Data Reporting
  • Marketing Information & Resources
  • Quality Withhold Methodology & Technical Notes
  • Chronic Care Improvement Programs & Quality Improvement Projects

Email us if you need more information about MMP requirements.

More information on each state's demonstration can be found on the Financial Alignment Initiative page.