• Tips for States with Dual Eligible Special Needs Plans Affected by 42 CFR §422.514(h) Federal Regulations

    In April 2024, CMS released new rules at 42 CFR §422.514(h) for D-SNPs with affiliated Medicaid managed care organizations (MCOs). This ICRC tip sheet provides (1) an overview of those new requirements, which take effect in 2027 and 2030, and a summary of rule exceptions, (2) illustrative examples and options for D-SNP compliance with each rule provision, and (3) action steps for states in working with D-SNPs to ensure compliance with these new rules.

    MORE

    A compass pointing toward the word "COMPLIANCE."

  • Key Medicare Advantage Dates

    This calendar of key Medicare Advantage (MA) dates was developed to assist states in the development and implementation of integrated care programs for people dually eligible for Medicare and Medicaid. The dates and information in this calendar are drawn from a more extensive calendar developed by the Centers for Medicare & Medicaid Services (CMS). That more extensive calendar, which CMS updates on an ongoing basis, is available at https://hpms.cms.gov/app/ng/home/.

    MORE

    Calendar date 15 circled in red with a pen tip pointing at it.

  • Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries

    States can allow or require D-SNPs that meet certain requirements to use default enrollment to align Medicare and Medicaid coverage for dually eligible individuals. Under default enrollment, D-SNPs may automatically enroll individuals who are enrolled in a comprehensive Medicaid managed care organization offered by the same parent organization as the D-SNP when those individuals first become eligible for Medicare Parts A and B (at the same time) due to age or disability.

    MORE

    Person walking with arrows on pavement pointing in multiple directions
Learn about D-SNP Contracting
Businesswoman signing contract
Request a State Data Profile
Calculator on top of papers with graphs
Request One-on-One Technical Assistance
People sitting in conference room

Key Upcoming Dates

May - July 2026 | Key Medicare Advantage dates
CMS releases the integrated Member ID card template for states that will have Applicable Integrated Plan (AIP) D-SNPs in CY2027, as well as model materials for certain states that choose to develop state-specific models with CMS for certain AIP materials.
May 2026 | Key Medicare Advantage dates
CMS releases CY2027 models for MA plan Annual Notice of Change (ANOC), Evidence of Coverage (EOC), Low Income Subsidy (LIS) rider, Part D Explanation of Benefits, formularies, transition notice, provider directory, and pharmacy directory.
May 8, 2026 | Key Medicare Advantage dates
MA organizations with D-SNP look-alike plans submit CY2027 transition plans to CMS.
Late May 2026 | Key Medicare Advantage dates
Qualification determinations provided to CY2027 applicants for new contracts or service area expansions.
May 22, 2026 | Key Medicare Advantage dates
CMS issues preliminary approvals/rejections for D-SNP lookalike transitions.

View Full Calendar