DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland 21244-1850 
 
Center for Medicaid and State Operations 
                              SMDL #08-005 
 
            August 7, 2008         
   
Dear State Medicaid Director: 
 
The Centers for Medicare & Medicaid Services (CMS) is releasing the new Integrated Medicare 
and Medicaid State Plan Preprint for States that want to integrate and coordinate Medicare and 
Medicaid services for dual eligible beneficiaries.  Attached to this letter are the instructions and 
Preprint template for State use.  
 
The State Plan Preprint for Integrated Care Programs was developed for States to use on a 
voluntary basis as a tool to demonstrate and explain the key features of their Integrated Care 
Programs.  The Preprint allows States the ability to highlight the arrangements provided between 
a State and Medicare Advantage Special Needs Plans (SNPs) that are also providing Medicaid 
services.  The Preprint also provides the opportunity for States to confirm that their integrated 
care model complies with both federal Medicaid statutory and regulatory requirements.  SNPs 
will continue to be required to comply with all Medicare statutory and regulatory requirements, 
including how they apply for SNP status, submit Medicare bids, and enter into a contract with 
CMS to provide Medicare services. 
 
It is important for States to understand that the Preprint does not replace the need for States to 
operate under the appropriate Medicaid statutory authorities and to be in compliance with both 
statutory and regulatory requirements.  States will still need to follow the usual process for 
submitting Medicaid waiver applications and contracts required under federal law to the 
appropriate CMS Regional and Central Office components.  
 
CMS hopes this Preprint will help facilitate States efforts to move toward developing integrated 
delivery system of care for dual eligibles.  The goal of providing the full array of Medicare and 
Medicaid benefits through a single health plan is to improve the quality of care for dual eligible 
beneficiaries with better care coordination and fewer administrative burdens. 
 
The CMS contact for the State Plan Preprint for Integrated Care Programs is Ms. Gale Arden, 
Director, Disabled and Elderly Health Program Group, who may be reached at 410-786-6810. 
 
Sincerely, 
 
         /s/ 
 
         Herb B. Kuhn 
         Deputy Administrator 
         Acting Director, Center for Me dicaid and State Operations 
 
Enclosure  Page 2  State Medicaid Director 
 
cc: 
 
CMS Regional Administrators 
 
CMS Associate Regional Administrators 
Division of Medicaid and Childrens Health 
 
Ann C. Kohler 
NASMD Executive Director 
American Public Human Services Association 
 
Joy Wilson 
Director, Health Committee 
National Conference of State Legislatures 
 
Matt Salo 
Director of Health Legislation 
National Governors Association 
 
Barbara Levin 
Director of Policy and Programs 
Association of State and Territorial Health Officials 
 
Christie Raniszewski Herrera 
Director, Health and Human Services Task Force 
American Legislative Exchange Council 
 
Debra Miller 
Director of Health Policy 
Council of State Governments