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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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