CC Crosswalk

CC Crosswalk.pdf

State Health Insurance Assistance Program (SHIP) Client Contact Form, Pubic and Media Activity Form, and Resource Report Form

CC Crosswalk

OMB: 0985-0040

Document [pdf]
Download: pdf | pdf
Revisions to Form CMS-10028A Client Contact (CC)
In April 2011, the Medicare-Medicaid Coordination Office awarded design
contracts to 15 states to implement State Demonstrations to Integrate Care for
Medicare-Medicaid Individuals (Dual eligible). The overall goal of this initiative is
to develop, test and validate fully integrated delivery system and care
coordination models. The Financial Alignment Initiative is a unique Federal-state
partnership to test aligning the service delivery and financing of the Medicare and
Medicaid programs to better serve Medicare-Medicaid individuals. As part of this
effort, there is a need for strong beneficiary support, education and outreach in
each State that is implementing a Financial Alignment model, including options
counseling for beneficiaries. State Health Insurance Assistance Programs (SHIPs)
and Aging and Disability Resource Centers (ADRCs) have longstanding history and
relationships with beneficiaries and are well situated to provide this service locally
in each State.
A key component of this initiative will be tracking and reporting on the types of
questions being asked and the type of information and assistance SHIPs/ADRCs
are providing to these dually eligible beneficiaries. This information will be
reported through the SHIP National Performance Reporting System and shared
with the Medicare-Medicaid Coordination Office on a quarterly basis to ensure
services to dual eligibles are within the scope of the cooperative agreement
requirements and support the Financial Alignment models.
The Client Contact form of the National Performance Reporting (NPR) system
contains 10 National Special Use Fields (SUFs) and will need to be expanded to
capture the data elements for the Duals Financial Alignment Program.
The NPR contractor will create the 20 Special Use Fields and will design the NPR
web entry screens and the NPR batch upload protocols to allow for the collection
of the designated data elements for Duals. See bottom of page 2 of the CC Form:
SUFs being added are 11 – 30.


File Typeapplication/pdf
AuthorGregory Price
File Modified2013-01-31
File Created2013-01-31

© 2024 OMB.report | Privacy Policy