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Appeals and grievance procedures must be comprehensive and accessible

Enrollees in integrated models may disagree with decisions the integrated model and its providers make about what services are needed and whether coverage for those services will be provided. They may...

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Medicare’s amount in controversy should not apply

This barrier to access to a hearing or to court review should not apply to dual eligibles pursuing appeals in integrated models.  Costs below the Medicare thresholds are well above the ability of dual...

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Benefits should continue pending an appeal; for LTTS aid paid pending should...

Integrated models should provide continued benefits while pursuing an appeal regardless of whether those benefits would be classified as Medicare or Medicaid benefits.  The PACE program currently...

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Provide fair timelines for filing appeals and fast decision deadlines

Dual eligibles need speedy resolution of appeals.  They cannot afford to pay for denied services and their medical needs are complex. Integrated models and government agencies should be held to strict...

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No more than five levels of appeal are needed; Beneficiaries should have...

An integrated appeal process should never exceed five levels of appeal and beneficiaries should not be required to pursue every level of appeal.  There should be no more than one internal, plan level...

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Follow Medicaid’s rules regarding notice timing and content

The Medicaid process of providing a notice prior to the provision or termination of a service is of critical importance for this population. Dual eligibles are unable to afford the risk of receiving...

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A Dedicated, Funded Ombudsman Program Is Essential

One risk of the dual eligible integration models is that new incentives will arise for plans and providers to deny needed care.  To address this risk, enrollees should have access to an independent...

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Analysis Compares Appeals Systems in Dual Eligible Demonstration Projects

NSCLC has published an advocacy tool that compares the design of the appeals systems for the six states that currently have a Memorandum of Understanding (MOU) with the Centers for Medicare and...

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