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Medicare Advantage Bid, Contract, Material, and Enrollment Processes: Key Considerations for State Contracting with D-SNPs

This technical assistance tool highlights key dates in (1) the CMS bid and contracting process for Medicare Advantage (MA) plans (including D-SNPs), (2) the processes used to develop material templates for MA plans (including integrated material templates for applicable integrated plans), and (3) the Medicare Advantage enrollment process.

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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.

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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.

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Latest Resources

Webinars and Trainings | June 2026

Implementing "Medicare-First" Exclusively Aligned Enrollment: Key Steps & Considerations for States

Tip Sheet | June 2026

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

Brief | June 2026

Key Steps and Considerations for States Using “Medicare-First” Exclusively Aligned Enrollment Processes with Dual Eligible Special Needs Plans (D-SNPs)

Technical Assistance Tool | May 2026

Medicare Advantage Bid, Contract, Material, and Enrollment Processes: Key Considerations for State Contracting with D-SNPs

Webinars and Trainings | April 2026

Promoting Provider Network Alignment to Improve Integration in D-SNPs

Key Upcoming Dates

July 6, 2026 | Key Medicare Advantage dates

Deadline for submission of D-SNP SMACs to CMS.

Late July - Early August 2026 | Key Medicare Advantage dates

CMS releases the Part D national average monthly bid amount, the Medicare Part D base beneficiary premium, the Part D regional low-income premium subsidy amounts, the MA regional PPO benchmarks, and the de minimus amount.

August – September 2026 | Key Medicare Advantage dates

Plan preview periods of Part C & D Star Ratings in HPMS.

August-September 2026 | Key Medicare Advantage dates

Plan preview periods of Part C & D Star Ratings in HPMS.

August 1, 2026 | Key Medicare Advantage dates

If, on or before this date, CMS issues a termination notice to an MA organization with an effective date of December 31, 2026, the MA organization must issue notices to the affected plan enrollees at least 90 days prior to the effective date of the term.

Medicare Advantage Bid, Contract, Material, and Enrollment Processes: Key Considerations for State Contracting with D-SNPs

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

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

Latest Resources

Key Upcoming Dates