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In addition, MA organizations can drop counties from their service areas if provider networks in those counties do not meet the standards, but this poses a problem for states with MLTSS programs that require their Medicaid contractors to offer a DSNP.[8] If the MA organization cannot offer a DSNP in a service area, then its companion Medicaid plan could lose its contract for that same area, causing the state to miss an opportunity to encourage enrollment in an aligned Medicare and Medicaid program

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