MDCH - Integrated Care for Persons Dually Eligible for Medicare and Medicaid

Integrated Care for Persons Dually Eligible for Medicare and Medicaid

The Michigan Department of Community Health (MDCH) is developing a demonstration to strengthen services and supports for individuals who are dually eligible for Medicare and Medicaid. In the demonstration, services and supports for persons who are dually eligible will be delivered by newly created Integrated Care Organizations (ICOs) and currently existing Prepaid Inpatient Health Plans (PIHPs). ICOs will be responsible for the provision of all physical health, long term care, and pharmacy services, while PIHPs will be expected to cover behavioral health and habilitative services for people with developmental disabilities, mental illness, or substance use issues. The ICOs and PIHPs will be connected through the Care Bridge, a care model that requires the coordination of services and supports between the two entities and involved providers.

Pending approval from the Centers for Medicare and Medicaid Services (CMS), MDCH aims to implement the program in January 2014. MDCH is currently negotiating a Memorandum of Understanding (MOU) with CMS to outline state and federal responsibilities for the demonstration as well as preparing a Request for Proposals (RFP) for entities interested in becoming ICOs. This webpage will be updated as the demonstration continues to develop.

NEW INFORMATION

Guidance on the Pharmacy Benefit and Plan Benefit Package

Guidance on Required Non-Part D Drugs for the Demonstration

Integrated Care Project Background

Information for Integrated Care Organizations

Contact Information

Those who wish to submit comments may do so by sending an e-mail to IntegratedCare@michigan.gov.

Comments can also be submitted through regular mail to:

Integrated Care

Medical Services Administration

PO Box 30479

Lansing, MI 48909-7979