Special Needs Plan Alliance

Lobbying - the Alliance works on initiatives to advance risk-adjusted payments for high-risk populations, medicare/medicaid integration, and to improve performance measurement to reflect populations.

Fall leadership meeting and spring meeting members-only round table - the Alliance hosts two 1.5 day meetings per year. The spring meeting is for members only and focuses primarily on Special Needs Plan policies and rule-making. The Alliance holds in-depth discussions regarding specific regulations and has open discussions with members on their challenges and strategies to address these. The fall meeting is open to both members and non-members. The fall meeting generally addresses broader topics - again focusing on policies and operations for Special Needs plans and medicare-medicaid plans. Representatives from centers for medicare and medicaid services ("cms") are invited to both meetings, and both meetings include education sessions addressing strategies to better serve high risk and vulnerable populations.

Legal, policy and program consulting - the Alliance meets regularly with cms on specific regulatory issues. The Alliance reviews all proposed rules and guidance, and prepares summaries for members and comment letters to agencies. The Alliance also occasionally uses its legal consultant to interpret some of the legal constraints to regulatory authority in its comment letters. The Alliance also addresses individual member concerns and may refer the issue to its legal consultant for recommendations. The Alliance has 5 regularly recurring standing meetings with members where it reviews a variety of policies and member questions that are then uses as a framework for the Alliance's follow-up to the administration and to members of congress.

Grants & projects - the Alliance contracts to work with organizations and government entities disseminating information on consumer and provider education related to integrated care.