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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

Mid-August 2026 | Key Medicare Advantage dates

CMS sends approval letters to D-SNP look-alikes for transitions and POVER processes.

Late August 2026 | Key Medicare Advantage dates

CMS notifies all D-SNPs of final determinations of integration status and sanctions based on CY2027 SMACs.

August 20, 2026 | Key Medicare Advantage dates

CMS releases CY2027 contract materials in HPMS for MA and Part D plans (including D-SNPs).

August 31, 2026 | Key Medicare Advantage dates

CY2026 Part C and D reporting requirements data submission for enrollment/disenrollment.

August 31, 2026 | Key Medicare Advantage dates

CY2027 contract execution deadline

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