One approach that recognizes these barriers is the Medicaid-capitated D-SNP model, which is not getting the attention it deserves. A D-SNP capitulated by Medicaid is an incredibly innovative way to place Medicaid and Medicare under one contract, in accordance with BBA integration requirements, but without the need for an MLTSS program. Essentially, a state makes available to its D-SNP contractors a capitulation payment to cover certain Medicaid services. The dollar amount of this capita, the specific services and requirements of Medicaid – they are all in the D-SNP contract (the “MIPPA” or “SMAC”). A separate Medicaid Managed care contract is not required for the D-SNP to meet hide or FIDE requirements. This initiative includes special efforts to address rural areas and Native American elders. You can access the MIPPA 2020 final contract by clicking on the following link (click here). • Non-companion SNPS (those that do not comply with an MCO CHC) are also eligible for MIPPA contracts and can use any combination of alternating quotas allowed by CMS. Since its adoption in 2008, MIPPA has helped more than one million low-income Medicare recipients access programs that make their health care and prescription fees more affordable. . . .