Advancing Integrated Care

Advancing Integrated Care for Beneficiaries Dually Eligible for Medicare and Medicaid

The National MLTSS Health Plan Association has taken a multi-pronged approach to advancing integrated care for dual eligible beneficiaries since its inception. This includes development of the Association’s proposal and policy priorities, convening and meeting with health plan association leadership and other stakeholders, and engagement with Hill staff to provide education and identify legislative champions. The goals of these activities are to increase public awareness of integration as an issue and to work towards legislative action to advance integration.

Comments on Simplifying Access to Medicare Savings Programs

The National MLTSS Health Plan Association (MLTSS Association) is pleased to provide input on the Aging & Disability Health Policy Lab's four draft state model policies to simplify access to the Medicare Savings Programs (MSPs). Affordable access to Medicare is foundational to ensuring members can obtain timely, necessary care. When low-income Medicare members struggle to afford their Part A and Part B premiums and cost sharing, they delay or forgo care, often until condition

Jul 17

MLTSS Association Auto-Enrollment Policy Proposal Resources

In 2025, the MLTSS Association published our Policy Proposals to Advance Integrated Care, which included our proposal on auto-enrollment. This proposal outlines two complementary pathways that can be utilized to promote enrollment of dually eligible individuals into integrated D-SNPs, ultimately increasing access to coordinated and person-centered care. These new accompanying resources provide additional rationale to support this proposal. Our brief Expanding Auto-Enrollment

May 13

Policy Proposals to Advance Integrated Care

Today approximately 10 percent of individuals who are dually eligible for both Medicare and Medicaid are enrolled in managed care plans that fully integrate their Medicare and Medicaid coverage. The remaining dually eligible individuals must navigate a complex system of overlapping coverage and disconnected services. Despite significant regulatory and legislative activity around advancing integrated care models at both the state and federal level, many barriers remain. The Na

May 11

MLTSS Association Signs on to MMIA Letter

The MLTSS Association signed on to a letter submitted by the Medicare-Medicaid Integration Alliance (MMIA) on January 22 nd . This letter, sent to Daniel Brillman, Deputy Administrator of CMS and the Director of CMCS, outlined the Alliance’s position on the Implementation of HR 1 and opportunities to enhance protections for dually eligible individuals. Specifically, this letter included recommendations for CMS on how to ensure that dually eligible individuals and caregivers,

Feb 3

Comments on the 2027 MA and Part D Proposed Rule

On January 25, 2026, the MLTSS Association submitted comments on the Contract Year 2027 Medicare Advantage and Part D Proposed rule. Many of the changes contemplated for CY 2027 in this proposed rule represent meaningful shifts in enrollment policy, contracting requirements, quality measurement, and plan operations. To be successful, these changes must be implemented on timelines that allow health plans and states sufficient opportunity to understand final requirements, make

Jan 28

New Resource for States on AIP Enrollment Lag Issue

The MLTSS Association has created a resource highlighting an operational issue in state Medicaid policy affecting some Dual Eligible Special Needs Plans (D-SNPs) that are Applicable Integrated Plans (AIPs), where timing gaps in enrollment can delay alignment with an individual's Medicaid plan. These gaps may cause temporary coverage misalignment, member confusion, and risk plans’ compliance with CMS AIP requirements. In this resource, we outline the implications of this issue

Dec 17, 2025

New Letter to CMS on AIP Enrollment Lag Issue and Recommendations

The MLTSS Association has written a letter to CMS highlighting an operational issue in state Medicaid policy affecting some Dual Eligible Special Needs Plans (D-SNPs) that are Applicable Integrated Plans (AIPs), where timing gaps in enrollment can delay alignment with an individual's Medicaid plan. These gaps may cause temporary coverage misalignment, member confusion, and risk plans’ compliance with CMS AIP requirements. In this letter, we outline the implications of this is

Nov 11, 2025

New Resource Comparing Integrated Care Options for Dually Eligible Individuals

The MLTSS Association has released a new resource comparing different integrated care options for dually eligible individuals across nine key domains. This educational resource highlights the key features, benefits, and challenges of each model. Ultimately, the MLTSS Association believes that D-SNPs are the only truly integrated and scalable model available for dually eligible individuals. We believe that the expertise, experience, and expansive reach of the D-SNP model can

Sep 15, 2025

The MLTSS Association and the SNP Alliance Release New Resource on SMAC Development

State Medicaid Agency Contracts (SMACs) are contracts between states and Medicare Advantage Organizations (MAOs) operating Dual Eligible...

Aug 28, 2025