CMS: Insurers need to create plans for dual eligibles

Politico Pro: CMS: Insurers Need To Create Dual Plans
Medicare Advantage insurers that cover some of the most expensive patients must develop individualized plans to coordinate care for each one, according to a final CMS rule issued Friday. The agency also formalized language in the Affordable Care Act requiring these so-called Special Needs Plans, which handle the costly population covered by both Medicare and Medicaid, to implement quality improvement programs and be certified in 2012 by the National Committee for Quality Assurance. The rule cleared the Office of Management and Budget yesterday and furthers an HHS initiative to improve coordination between Medicare and Medicaid for dual eligibles, who typically have either chronic conditions such as diabetes or reside in nursing homes and account for a disproportionate share of federal health spending (Norman, 8/26).