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Dual Eligible Special Needs Plan – Applicable Integrated Plan (DSNP-AIP)
A dual eligible special needs plan determined to be an applicable integrated plan; it must also submit Table 6.
Sponsoring organizations determined to be an Applicable Integrated Plan (AIP) must submit Table 6 for their Dual Eligible Special Needs Plan contracts and PBPs. DSNP-AIPs face some different timeframes, such as written denial notice within 3 days for expedited ODs and 30 days for payment reconsiderations. They populate the grievance universe with Medicare-coverage grievances only.
Source: ODAG protocol, Timeliness 1.3, PDF p. 5; Universe Submissions, PDF p. 15.