NSCLC: New Issue Brief Unfinished Business: Designing Appeals Procedures in the Dual-Eligible Demonstrations
From our colleagues at NSCLC:
Under the Affordable Care Act, a number of states are participating in financial alignment demonstrations that combine the delivery of Medicare and Medicaid services for dual eligible beneficiaries. Even though financial alignment demonstrations are already “live” in five states with tens of thousands receiving services through demonstration plans, the appeal systems for the demonstrations in all participating states are still a work in progress, making it difficult for beneficiaries to navigate.
This tool, Unfinished Business, is an update on NSCLC’s September 2013 analysis of appeals processes in demonstrations in six states. Unfinished Business helps stakeholders focus their advocacy about appeals on areas where a consumer voice can have the most potential to affect programs, by highlighting the many areas where appeal rights and procedures have not yet been fully developed.
Ten states are participating (CA, IL, MA, MI, NY, OH, SC, TX, VA and WA), with one more, Minnesota, pursuing a similar but alternate model.