What Services Are Included In The Capitated Rates Paid To Managed Care Programs Participating In The CMS Dual Eligible Demonstration Projects?

The Centers for Medicare & Medicaid Services (CMS) launched state demonstrations to integrate care for dual eligible individuals in April 2011 in an effort to expand access to integrated programs for full benefit dual eligibles. Full dual eligibles meet eligibility requirements for both Medicare and Medicaid. Their Medicaid eligibility is based on either income or a determination that their high medical costs make them “medically needy.” Full benefit dual eligible are entitled to receive “full” Medicaid benefits – nursing home and other institutional care, home care, dental care, mental health care and therapy, eye care, transportation to and from providers, and . . .