Issue Briefs for Contracting with Health Plans
The Centers for Medicare and Medicaid Services (CMS) offer Resources for Integrated Care that supports providers integrating benefits for people receiving both Medicare and Medicaid. This website has a variety of useful free resources for long term care providers.
Specifically, in response to the growth of both Medicare Advantage and Medicaid managed care long term services and supports (LTSS), the agency has several briefs to support provider interactions with health plans:
- 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.