CMS Issues Letter to State Medicaid Directors

On April 24, 2019, the Centers for Medicare and Medicaid Services (CMS) sent a letter to State Medicaid Directors inviting states to partner with CMS to test innovative approaches to better serve those who are dually eligible for Medicare and Medicaid.

Approaches discussed in the State Medicaid Directors letter include:

  • The Capitated Financial Alignment Model: Through a joint contract with CMS, states and health plans, this model option creates a way to provide the full array of Medicare and Medicaid services for enrollees for a set capitated dollar amount.
  • Managed Fee-for-Service Model: This model is a partnership between CMS and the participating state and allows states to share in Medicare savings from innovations where services are covered on a fee-for-service basis.
  • State-Specific Models: CMS is open to partnering with states on testing new state-developed models to better serve dually eligible individuals and invite states to approach CMS with ideas, concept papers and/or proposals.

This letter complements the December 2018 State Medicaid Director Letter that discussed improving are for dually eligible individuals. The letter from CMS Administrator Seema Verma to state governors is also available here.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Katie Weider Waldo at 212-547-5433/