Medicare Advantage Special Needs Plans:

A Beneficiary Perspective

October 18, 2007

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Medicare Advantage Special Needs Plans:  
A Beneficiary Perspective

 

A working conference convened by the Center for Medicare Advocacy, Inc., and supported by The Commonwealth Fund, an independent foundation working toward health policy reform and a high performance health system.
 

October 18, 2007

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Conference Agenda

 

 

8:00 a.m.     Registration and Continental Breakfast

 

8:45 a.m.     Welcome

 

Judith A. Stein, Executive Director, Center for Medicare Advocacy

 

Stuart Guterman, Senior Program Director, Program on Medicare’s
Future, The Commonwealth Fund

 

Session I

Introductions

 

Moderator: Judith A. Stein

 

8:50 a.m.     Participant Introductions and Sharing of Experiences with Special
                   Needs Plans

           

Session II

What Makes SNPs Special for Beneficiaries?

 

Moderator: Patricia Nemore,
Senior Policy Attorney, Center for Medicare Advocacy

 

10:00 a.m.    "Medicare Advantage Special Needs Plans: Overview of Law and
                    Regulations"

 

 Vicki Gottlich, Senior Policy Attorney, Center for Medicare
           Advocacy

 

10:10 a.m.    Participant Discussion

  • What is the added value of disproportionate enrollment?

  • How are beneficiaries affected by CMS’ decision to define SNPs through sub-regulatory guidance and contracts rather than regulation?

10:45 a.m.    Break

 

Session III

How Does the SNP-State Connection Help Beneficiaries?

 

Moderator: Pamela Meliso,
Senior Attorney, Center for Medicare Advocacy

 

11:00 a.m.   "Connecting SNPs with State Medicaid Programs"

 

Charles Milligan, Executive Director, Center for Health Program Development and Management, University of Maryland, Baltimore County

 

11:10 a.m.       Participant Discussion

  • What additional services should Medicare SNPs provide that are not covered by state Medicaid programs?

  • How can SNPs add value for persons receiving services under Medicaid home and community-based waivers or in institutions?

  • How can SNPs improve beneficiaries’ access to primary care and improve access to other providers, including specialists?

  • What is it about SNPs that makes their existence “an unprecedented opportunity” for better coordination between Medicare and Medicaid?

Session IV

Working Lunch

 

Moderator: Alfred J. Chiplin, Jr.,

Senior Policy and Managing Attorney, Center for Medicare Advocacy

 

12:30 p.m.    Gather Food / Break

 

12:50 p.m.     "Medicare Advantage Special Needs Plans: Overview of Issues by
                    Type of Plan"

 

                    James M. Verdier, Senior Fellow, Mathematica Policy
                    Research, Inc.

 

1:00 p.m.      Participant Discussion

 

1:30 p.m.      Break

 

Session V

The Beneficiary Experience

 

Moderator: Brad Plebani,
Deputy Director, Center for Medicare Advocacy

 

1:45 p.m.      "The Medicare Advantage Special Needs Plan Experience:
 Beneficiary Perspective from Pennsylvania" 

 

 Alissa E. Halperin, Managing Attorney, Pennsylvania Health Law            Project

 

1:55 p.m.      Participant Discussion

  • What statutory changes are necessary to ensure that SNPs are a viable choice for beneficiaries? 

  • What should SNPs be required to demonstrate to be approved by CMS and what are essential contract provisions?

  • What are the minimal and optimal elements of SNP coordination with Medicaid?

  • What data, such as encounter data, are needed to understand beneficiary experiences with SNPs?

3:15 p.m.      Break

 

Session VI

Areas of Agreement

 

Moderator: Nancy Coleman,
Independent Consultant

 

3:30 p.m.      Gathering Consensus Recommendations and Formulating the
                    Challenges Ahead

 

4:45 p.m.      Concluding Remarks

 

Judith A. Stein and Stuart Guterman

 

Contact us at: mrubin @ medicareadvocacy.org (remove spaces)