Integrating Appeals Processes for Dually Eligible Beneficiaries

The Commission has expressed interest in exploring opportunities for administrative alignment between Medicare and Medicaid. This presentation focuses on streamlining the appeals process between the two programs. Both New York and Minnesota have taken steps to integrate the separate Medicare and Medicaid appeals processes that dually eligible beneficiaries have to navigate in order to appeal a coverage decision made by their health plan. This presentation explains the existing process, identifies key differences between Medicare and Medicaid appeals, and discusses federal and state efforts to streamline appeals for dually eligible beneficiaries.