ACL’s Duals Demonstration Ombudsman Technical Assistance Program provides technical assistance to support the Centers for Medicare and Medicaid Services (CMS) state grantees implementing an ombudsman program as a part of CMS’s Support for Demonstration Ombudsman Programs Serving Beneficiaries of Financial Alignment Models for Medicare-Medicaid Enrollees. This Financial Alignment Initiative addresses issues of care coordination caused by financial misalignment between Medicare and Medicaid. In response to these concerns, CMS provides funding for two models that aim to improve state coordination of financing of Medicare and Medicaid. These programs focus on integrating primary care, acute care, behavioral health care, and long-term services and supports for beneficiaries that are dually-eligible for both Medicare and Medicaid.
ACL assists state Ombudsman grantees by helping them:
- Plan and monitor program progress
- Meet data collection and reporting requirements
- Collaborate with other grantees to share best practices and ideas
- Develop training materials
Information for Beneficiaries
Each demonstration includes an Ombudsman Program funded by CMS to help people solve problems related to their services:
- California
Demonstration: Cal MediConnect
Ombudsman: Health Consumer Alliance - Illinois
Demonstration: Medicare-Medicaid Alignment Initiative (MMAI)
Ombudsman: Medicare-Medicaid Alignment Initiative (MMAI) Ombudsman - Massachusetts
Demonstration: One Care
Ombudsman: My Ombudsman - Michigan
Demonstration: MI Health Link
Ombudsman: MI Health Link Ombudsman - Ohio
Demonstration: MyCare Ohio
Ombudsman: MyCare Ohio Ombudsman - Rhode Island
Demonstration: Integrated Care Initiative
Ombudsman: Integrated Care Initiative Ombudsman Program - South Carolina
Demonstration: Healthy Connections Prime
Ombudsman: Healthy Connections Prime Ombudsman Program
In addition to CMS grantees, ACL works with aging and disability organizations, advocacy groups, and other key stakeholders to help dually-eligible beneficiaries to receive person-centered care and support.
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