Relevant to: MAOs

The purpose of this memorandum is to share updates to section 20.2.4.2 (D-SNPs With or Without Medicare Zero-Dollar Cost Sharing) of Chapter 16-B of the Medicare Managed Care Manual regarding which plans qualify as Medicare Zero-Dollar Cost Sharing D-SNPs, as well as three new sections added to Chapter 16-B as follows:

  • 20.2.4.2.1 Definition of Medicare Zero-Dollar Cost Sharing Dual Eligible Special Needs Plans;
  • 20.2.4.2.2 Special Considerations for PPO D-SNPs; and
  • 20.2.4.2.3 Medicare Zero-Dollar Cost Sharing D-SNPs and Enrollee Lapse in Medicaid
    Eligibility.

See the full guidance for more information.

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