Our Issues

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 N

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

The MLTSS Association has released a new resource comparing different integrated care options for dually eligible individuals across nine...

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

On May 12th, the MLTSS Association submitted comments on a  Request for Information  (RFI) from the Office of Management and Budget (OMB)...

On April 29th, the MLTSS Association sent a letter to Abe Sutton (Director, Center for Medicare and Medicaid Innovation) and Gary Bacher...

The MLTSS Association has submitted a letter to members of Congress that provides an overview of the Association and the populations we...

The MLTSS Association has created two new educational resources, including an overview of the MLTSS Association and a primer on MLTSS &...

On March 17th, the MLTSS Association, along with the Special Needs Plan Alliance (SNP Alliance), the Association for Community Affiliated...

The MLTSS Association and SNP Alliance have collaborated to develop state scenario slides analyzing how the CY 2025 Medicare Advantage...

The MLTSS Association has created an educational resource containing common challenges with State Medicaid Agency Contracts (SMACs) and...

On January 27th, 2025, the MLTSS Association submitted comments on the 2026 MA and Part D Proposed Rule. Among its provisions, this rule...

On January 21st, 2025, the MLTSS Association submitted comments on proposed changes to the 2027 State Medicaid Agency Contract (SMAC)...

The CY 2025 Medicare Advantage and Part D final rule, published in April 2024, introduced several important changes to enrollment...

MLTSS Association staff presented on "State Scenarios for New CMS Integration Requirements" at the Special Needs Plan (SNP) Alliance Fall...

The MLTSS Association and SNP Alliance sent a letter to Congress with comments on the DUALS Act of 2024, which aims to improve...

On April 4th, CMS released the Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program and the Medicare...

The MLTSS Association and the SNP Alliance sent a letter to Congress on bipartisan integrated care legislation that proposes to advance...

On January 31st, 2024, CMS published the Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA)...

On January 5th, 2024, the MLTSS Association submitted comments on CMS’ 2025 Medicare Advantage and Part D proposed rule. Among its...