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Update to Section 20.2.1 and 20.2.5-20.2.7 on the definitions of dual eligible special needs plans (D-SNPs) and additional requirements for certain D-SNPs

The updated section now better reflects current regulatory requirements. Changes are as follows:
We added language to define D-SNPs, HIDE SNPs, CO SNPs, and applicable integrated plans and amended language defining FIDE SNPs
We updated the section on frailty adjustments for D-SNPs
We added a new section describing Medicaid carve-outs
We added a new section describing D-SNP only contracts

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 12, 2024

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.