# DUALS Act of 2024 Summary
The DUALS Act establishes new integrated care programs for the roughly 12 million Americans eligible for both Medicare and Medicaid (called "dual eligible" individuals). The bill requires states to develop and operate comprehensive care models that coordinate Medicare and Medicaid benefits, allowing these individuals to receive primary care, behavioral health services, long-term care, and other supports through a single unified plan rather than navigating two separate systems.
Each state must select a program model within one year and begin enrolling dual eligible individuals by year four. Individuals will be automatically enrolled with the option to opt out, assigned a single care coordinator to manage their care, and provided with a comprehensive care plan addressing their medical, behavioral, social, and support needs. The federal government will pay Medicare's share of costs while states pay Medicaid's share through capitated (fixed monthly) payments to the plans.
The bill establishes the Federal Coordinated Health Care Office to oversee implementation, develop unified appeals processes, create quality measures, and collect data on program performance. It also provides $50 million annually for state administrative expenses and $50 million for grants to community organizations to help enroll eligible individuals. States receive additional funding for shared savings if the integrated programs reduce spending.
The legislation also expands the PACE program (a model offering community-based care to seniors), allowing enrollment at any age for Medicare beneficiaries, year-round applications from new providers, and Medicare-only enrollees to choose their own prescription drug plans.
Take Action
Your position
Add a comment
to comment on this bill.
Annotate the text
Highlight any passage on the Summary or Full Text tab to attach a note. Annotations appear on the Annotations tab.