The recently released 2020 Medicare Call Letter provides guidance to Medicare Advantage (MA) plans on new non-health supplemental benefits for chronically ill individuals. MA plans will have greater flexibility to offer a range of supplemental benefits tailored to the specific needs of these individuals, if the benefits have a reasonable expectation of improving or maintaining the health or overall function of the individual as it relates to their chronic condition or illness. Supplemental benefits can include providing meals beyond a limited basis, transportation for non-medical needs, and home environment services.
Resources for Integrated Care (RIC) invites you to explore the resources linked below that may assist health plans and community-based organizations (CBOs) in building successful contractual relationships.
RIC Briefs for Health Plans
- Contracting with Providers: Considerations for health plans as they enter into contractual agreements with LTSS and HCBS providers.
- Identifying & Engaging Behavioral Health-Focused LTSS Providers: Key considerations for identifying and engaging community-based behavioral health direct service worker programs.
- Identifying Community-Based Resources: Examples of community-based resources health plans may consider engaging to address member needs.
RIC Briefs for LTSS and HCBS Providers
- Contracting with Health Plans: General considerations for organizations when contracting or entering into agreements with health plans.
- Billing for Services: Key issues for LTSS providers to consider when billing or submitting claims to health plans.
- Issues HCBS Providers may Negotiate with Health Plans: Issues that may be addressed and negotiated in contracts health plans offer to LTSS providers.
Learn More: Health Plan & CBO Partnership