2020 Outlook: SNPs Look to States, CMS for Direction on Duals Integration

For Medicare Advantage Special Needs Plans (SNPs) and other insurers serving individuals who are eligible for both Medicare and Medicaid, 2020 “will be the year of building momentum for integration of dual eligibles,” declares Cheryl Phillips, M.D., president and CEO of the SNP Alliance.

More than 3.1 million MA beneficiaries are currently enrolled in a SNP, including nearly 2.7 million individuals served by a Dual Eligible SNP (D-SNP). The plans, which can also take the form of Chronic Condition SNPs (C-SNPs) or Institutional SNPs (I-SNPs), were authorized under the Medicare Modernization Act of 2003 and went through a series of brief reauthorizations until the Bipartisan Budget Act of 2018 granted them permanent authorization. That legislation called for D-SNPs and states to better unify appeals and grievances processes across the Medicare and Medicaid programs and set new minimum standards for D-SNPs integrating Medicaid benefits.

© 2021 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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