On April 24, 2019, the Centers for Medicare & Medicaid Services (CMS) released this letter to state Medicaid directors. The letter seeks to encourage State Medicaid directors to collaborate with CMS in attempts to reform the accessibility of long-term care for dual eligibles. The letter contains the opportunity to participate in three models: the integrating care through capitated financial alignment model; integrating care through managed fee-for service model; and state-specific models . . .