Coordination Only Dual Special Needs Program (CO D-SNP)

Background
The State of Nevada, through the Department of Health and Human Services (DHHS) and the Division of Health Care Financing and Policy (DHCFP), is seeking proposals for a Coordination Only Dual Special Needs Program (CO D-SNP). This program aims to provide services to individuals who are eligible for both Medicare and Medicaid, known as Dual Eligibles.

The DHCFP is responsible for administering the CO D-SNP program, which will result in the award of State Medicaid Agency Contracts (SMAC) to qualified Medicare Advantage Plans. The goal is to ensure quality care coordination for these members and reduce confusion between their Medicare and Medicaid benefits.

Work Details
The selected Medicare Advantage Plans will be responsible for:
1. Coordinating delivery of Medicaid benefits and providing coverage of Medicaid services, including long-term services and supports and behavioral health services.
2. Ensuring enrollees receive quality services and enhanced coordination between their Medicare and Medicaid benefits.
3. Implementing care management strategies for high-risk beneficiaries, including case management, health risk assessments, and facilitating Medicaid eligibility redeterminations.
4. Establishing an Enrollee Advisory Committee to gather feedback from members.
5. Providing supplemental benefits such as dental, vision, hearing aids, transportation, personal emergency response systems, meals post-acute care, fitness packages, and over-the-counter benefits.

Period of Performance
The contract term is five years from January 1, 2026, through December 31, 2030, with an option for a two-year extension subject to approval.

Place of Performance
The services will be provided across all counties in Nevada with a phased-in approach starting with urban areas in 2027.