全球智库信息集成服务系统(G2TT): Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight

G2TT

来源类型	Publication
来源ID	ICRC Tip Sheet
	Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight
	Ryan Stringer; Nancy Archibald
发表日期	2018-06-30
出版者	Washington, DC: Integrated Care Resource Center
出版年	2018
语种	英语
概述	This brief describes how D-SNPs can request and use CMS audit reports to oversee D-SNPs operating in their jurisdictions.",
摘要	Key Findings: Medicare program audits may reveal authorization, appeal, and grievance issues, inadequate compliance program mechanisms, and care coordination issues that impact Medicaid benefits. States can find audit summary information for Medicare Part C and Part D sponsors from prior year audits on the CMS Medicare program audit results website. States can use their contracts with D-SNPs or contact MMCO to obtain full Medicare program audit reports. The Centers for Medicare & Medicaid Services (CMS) periodically conducts Medicare program audits of organizations sponsoring Medicare Advantage plans, including Dual Eligible Special Needs Plans (D-SNPs). To help oversee their contracts with D-SNPs and Medicaid managed care organizations, states may find Medicare program audit reports issued by CMS, available from the Medicare-Medicaid Coordination Office (MMCO), to be useful tools. States can use the results of Medicare program audits to identify performance issues impacting dually eligible beneficiaries’ receipt of care coordination, long-term services and supports, durable medical equipment, and other services, and incorporate that information into their audit and oversight activities. Insights from Medicare program audits can help states and CMS to coordinate their audit activities in order to improve D-SNP performance across Medicare and Medicaid benefits.
URL	https://www.mathematica.org/our-publications-and-findings/publications/tips-to-improve-medicare-medicaid-integration-using-d-snps-using-medicare-program-audit-reports
来源智库	Mathematica Policy Research (United States)
资源类型	智库出版物
条目标识符	http://119.78.100.153/handle/2XGU8XDN/489295
推荐引用方式 GB/T 7714	Ryan Stringer,Nancy Archibald. Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Using Medicare Program Audit Reports to Improve Managed Care Organization Oversight. 2018.

条目包含的文件
文件名称/大小	资源类型	版本类型	开放类型	使用许可
ICRC DSNP TipSheet U（223KB）	智库出版物		限制开放	CC BY-NC-SA	浏览