Medicare-Medicaid Plan (MMP) Enrollment
| SPOTLIGHT & RELEASES |
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10/02/2019 - MMP Enrollment Technical Guidance Version 3.1 (for submitting enrollment-related transactions to CMS) |
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09/10/2019 - MMP Enrollment Guidance Appendix 5: Michigan (PDF) (08/29/2019) |
States participating in the capitated model demonstrations are required to follow the below National MMP Enrollment Guidance & Exhibits, as well as utilize the enrollment resources listed, to ensure individuals have full access to seamless, high quality integrated health care. Note that in almost all cases the state Medicaid agency and enrollment broker administer enrollment processes.
More information on enrollment technical resources & related enrollment guidance is available below:
- MMP Enrollment Technical Guidance Version 3.1 (for submitting enrollment-related transactions to CMS)
- Medicare Advantage and Prescription Drug Plan Communications User Guide (PCUG) Manual (revised quarterly)
- Electronic Retroactive Processing Transmission (eRPT) Training for MMPs
- Enrollment Data Validation (EDV) process for States and MMPs (04/25/2014) (PDF)
- MMP Monthly Enrollment Payment Data Guidance (06/14/2014) (PDF)
- Integrated Care Resource Center (ICRC) technical enrollment webinars
Additional memos on enrollment & disenrollment are available below:
- Clarification of Medicaid Provider Enrollment Provisions for Services Provided by Integrated D-SNPs & MMPs (04/22/2019) (PDF)
- Coordinating Passive Enrollment with Medicare Reassignment (07/24/2019) (PDF)
- Memo to Long Term Care Facilities on Disenrollment Issues (05/26/2015) (PDF)
Training resources on enrollment processing are available below:
Appendix 5 is a state-specific document that contains a state's detailed description of policies related to enrollment, as well as Medicaid-specific requirements and functions.
MMP Enrollment Guidance Appendix 5 documents: