A Summary of Beneficiary Protections in the First Dual Eligible Demonstration
On July 18, 2013, Massachusetts became the first state to sign a three-way contract for its dual eligible demonstration project. The Medicare-Medicaid Coordination Office in the Centers for Medicare and Medicaid Services published the three-way contract signed with the Commonwealth of Massachusetts, and the three managed care plans participating in that state's dual eligible demonstration.
NSCLC has prepared a summary of consumer protections in the Massachusetts contract, including information on:
Enrollment
Care Team and Care Coordinator
Assessments
LTSS and Supplemental Services
Care Continuity
Appeals
The Massachusetts three-way contract is useful as a starting point for understanding the general structure of three-way contracts and for thinking about how to address consumer protections in three-way contracts that are being negotiated in other demonstration states.
For more information on dual eligible demonstration projects, visit NSCLC's dual demonstration website, www.dualsdemoadvocacy.org. The site contains information and tools to help state and national advocates be more effective in representing consumers through the planning and implementation of the demonstrations.
Case consultation help for advocates
NSCLC staff are available to help advocates with answers to questions about program rules and requirements, reviewing and analyzing pleadings, commenting on proposed litigation, assisting in the formulation of strategies, drafting opinion letters and providing memoranda, articles and other written materials.
