Special Needs Plans: A Guide to Eligibility, Benefits, Model of Care, and Regulatory Requirements
Activity description
A special needs plan (SNP) is a Medicare Advantage coordinated care plan specifically designed to provide targeted care; it limits enrollments to special needs individuals. The Centers for Medicare & Medicaid Services (CMS) has identified certain populations as having special needs that require enhanced or specialized standards of health care. The goals of this learning path are to create an understanding of the different SNPs offered, who is eligible and the related CMS and National Committee for Quality Assurance requirements.
Course last reviewed: 6/26/2023
Provided by
This activity is provided by Optum Health Education and Optum.
Commercial support
No commercial support was received for this activity.
Hardware/Software Requirements
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Target Audience
This activity is designed to meet the educational needs of physicians, PAs, nurses, nurse practitioners, case managers, social workers, and other health care professionals who have an interest in or serve the special needs population.
Learning Objectives
At the end of this educational activity, participants should be able to:
- Identify the types of SNPs.
- Determine who is eligible for SNPs.
- Describe what is covered in SNPs.
- Identify the CMS requirements related to SNPs.
- Determine how to utilize the Health Risk Assessment (HRA) to create an individualized care plan (ICP).
- Describe how the interdisciplinary care team is created and the ICP is shared.
- Describe how the transition of care ensures continuity of care.
- Explain the importance of CMS requirements as they relate to SNPs.
Faculty/Planners
Rebecca Gleason, RN, CCM
Clinical Planner
Optum Health Education
Katherine Dittmer BSN, RN
Associate Director
Clinical Adherence and Remediation
Clinical Consistency and Safety
Clinical Performance
Optum
Jennifer Every BSN, RN
Training Consultant
Clinical Adherence and Remediation
Clinical Consistency and Safety
Clinical Performance
Optum
Katie Shelton MSN, RN, CCM
Training Consultant
Clinical Adherence and Remediation
Clinical Consistency and Safety
Clinical Performance
Optum
Janet Thomas RN, BSN
Sr. Clinical Quality Analyst
Clinical Adherence and Remediation
Clinical Performance
Optum
Disclosures of relevant financial relationships
In accordance with the Accreditation Council for Continuing Medical Education's (ACCME) Standards for Integrity and Independence in Accredited Continuing Education, Optum Health Education (OHE) requires all those in control of educational content to disclose their financial relationships with ineligible companies within the prior 24 months. Ineligible companies are defined by the ACCME as companies whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients. Individuals must disclose all financial relationships, regardless of the amount, with ineligible companies and regardless of their view of the relevance of the relationship to the education. OHE ensures that the content is independent of commercial bias.
The activity faculty/planners have no financial relationships to disclose.
Method for calculating CE credit
CE credit was calculated by the complexity of content.
Accreditation StatementIn support of improving patient care, this activity has been planned and implemented by Optum Health Education and Optum. Optum Health Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.
Credit Designation Statements
Nurses
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.
Nurse practitioners
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
Physicians
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
PAs
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
Case managers
The Commission for Case Manager Certification has approved this program for a maximum of 1.00 clock hours for Certified Case Managers (CCM).
Social workersAs a Jointly Accredited Organization, Optum Health Education is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Optum Health Education maintains responsibility for this course. Social workers completing this course receive 1.00 enduring continuing education credits.
Attendance
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization with which they wish to obtain credit.
Available Credit
- 1.00 AMA - Physicians
- 1.00 ANCC - Nurses
- 1.00 Attendance - General Attendance
- 1.00 CCMC - General - Case Managers
Prior to beginning this activity, please ensure you are using the web-browser Chrome and disable any pop-up blocking software. Click here for information on how to enable pop-ups.
You must be logged into your account to participate in this activity. Get started by clicking “Continue” and taking the module “Special Needs Plan (Module 1)”; then follow the prompts at the bottom of the screen. At the end of the activity, you will be able to view, save or print your certificate of participation. A complete listing of all of your activities can be found under “My Account”, “My Activities.”