Analysis Compares Appeals Systems in Dual Eligible Demonstration Projects

NSCLC has published an advocacy tool that compares the design of the appeals systems for the six states that currently have a Memorandum of Understanding (MOU) with the Centers for Medicare and Medicaid Services for dual eligible demonstration projects.

Creating an integrated appeals system for Medicare and Medicaid-covered services is one of the most difficult issues facing states involved in these projects. The paper looks at how the states handle issues including levels of appeal, timeframes, aid paid pending during appeals and treatment of overlapping services.

The analysis also gives advocates benchmarks against which they can compare their own state’s plans for appeals processes in such projects. It also highlights areas that are particularly difficult to navigate or that need better elaboration than is found in any existing MOU.

Read NSCLC’s advocacy tool, “Appeals Processes in the Dual Eligible Demonstrations



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