Highly integrated dual eligible special needs plan

Highly integrated dual eligible special needs plan means a dual eligible special needs plan offered by an MA organization that provides coverage, consistent with State policy, of long-term services and supports, behavioral health services, or both, under a capitated contract that meets one of the following arrangements -
(1) The capitated contract is between the MA organization and the Medicaid agency; or
(2) The capitated contract is between the MA organization's parent organization (or another entity that is owned and controlled by its parent organization) and the Medicaid agency.

Source

42 CFR § 422.2


Scoping language

As used in this part -

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