CMS to open Direct Contracting Model to Medicaid managed care organizations

Medicaid managed care organizations with enrollees dually eligible for Medicare can participate in the Direct Contracting Model’s Professional and Global Options beginning in January 2022, the Centers for Medicare & Medicaid Services announced yesterday.

Medicaid MCOs must have at least 3,000 aligned beneficiaries and obtain a letter of support from their state Medicaid agency to participate in the model, which offers two risk-sharing options and is set to begin for other entities next April.

The agency expects to provide more information on the risk-sharing options available to MCOs when it requests applications for the DC model early next year.