• 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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  • 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/.

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Key Upcoming Dates

April 27, 2026 | Key Medicare Advantage dates
CY2025 Part C and D Reporting Requirements deadline for D-SNP Transmission of Admission Notification and Medicare Prescription Payment Plan.
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.

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