Federal Authority for Medicare Special Needs Plans and their Relationship to State Medicaid Programs

This Brief reviews the history and current status of federal special needs plans (SNPs) authority, with particular attention to provisions of interest to state Medicaid programs that have or are considering entering into contracts with SNPs to integrate or coordinate Medicaid long-term care services with Medicare primary, acute and prescription drug services for dually eligible beneficiaries. SNPs have been promoted as a "mainstream" vehicle for integrating Medicare and Medicaid services, but to date, most SNPs have had no formal relationships with state Medicaid programs. In the future, SNPs proposing to serve dually eligible beneficiaries will be required to have contracts with state Medicaid programs. This and other key changes to the program are outlined in this Brief. [14 PDF pages]