A bipartisan group of senators is introducing legislation to require states to offer integrated Medicaid and Medicare plans to dual-eligible beneficiaries.
Led by Louisiana Sen. Bill Cassidy, MD, the "Delivering Unified Access to Lifesaving Services Act of 2024" would require states to offer at least one comprehensive integrated Medicare-Medicaid plan.
Around 12.2 million people are eligible for both Medicare and Medicaid coverage based on their age, income and disability status. Dual-eligible beneficiaries are often enrolled in two seperate Medicare and Medicaid plans, which can make it difficult to coordinate care.
Here are five things to know about the legislation:
- Twelve states have participated in a pilot program to test integrated Medicaid and Medicare plans. The results have not shown consistent improvement in outcomes, NPR reported March 14.
- The legislation would crack-down on "look-alike" D-SNP plans — Medicare Advantage plans marketed to dual-eligible individuals that do not coordinate benefits.
- The proposed bill would also require all states to allow Program of All-Inclusive Care for the Elderly plans and lower the eligibility age for the model to 55.
- The Alliance for Community Health Plans, PACE organizations and several other providers endorsed the legislation.
- Dr. Cassidy told NPR the legislation has slim odds of passing this session but said he believes Congress will eventually be compelled to act on the issue.
Read more here.