Medicare and Medicaid: Consumer Protection Requirements Affecting Dual-Eligible Beneficiaries Vary across Programs, Payment Systems, and States

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By Kathleen M. King (au)
Year: 2012
Pages: 74
Binding Paperback
ISBN 978-1-4578-4189-7

Product Code: 1457841894

Description

Dual-eligible beneficiaries are low-income seniors and individuals with disabilities enrolled in Medicare and Medicaid. In 2010, there were about 9.9 million dual-eligible beneficiaries. Both programs have requirements to protect the rights of beneficiaries. These requirements are particularly important to dual-eligible beneficiaries, who must navigate the rules of both programs and generally have poorer health status. To help inform efforts to better integrate the financing and care for dual-eligible beneficiaries, this report (1) compared selected consumer protection requirements within Medicare FFS (fee-for-service) and Medicare Advantage (MA), and Medicaid FFS and managed care; and (2) described related compliance and enforcement actions taken by the Centers for Medicare & Medicaid Services (CMS) and selected states against managed care plans. Tables and figures. This is a print on demand report.

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