Update to Section 20.2.4.2 on D-SNPS With or Without Medicare Zero-Dollar Cost Sharing.
The updated section now better reflects current regulatory requirements. Changes are as follows:
• We added language encouraging states and D-SNPs to finalize D-SNP eligibility criteria in their State Medicaid Agency Contracts in advance of bid submission.
• We added a new section providing more detail on the definition of Medicare Zero-Dollar Cost Sharing D-SNPs, as well as describing the information on Zero-Dollar Cost Sharing D-SNPs available in Medicare Plan Finder.
• We added a new section describing requirements for D-SNP PPOs designated as Zero-Dollar Costing Sharing DNPs.
• We added a new section describing options for Zero-Dollar Cost Sharing D-SNPS when enrollees have a lapse in Medicaid eligibility.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 29, 2023
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