D-SNPs: Integration & Unified Appeals & Grievance Requirements

D-SNPs: Integration & Unified Appeals & Grievance Requirements


10/04/2023: CMS released the Integration Status for Contract Year 2024 D-SNPs. More information is available below.
09/19/2023: CMS released the List of Contract Year 2023 D-SNP Look-AlikesMore information is available below.


The Bipartisan Budget Act (BBA) of 2018 permanently authorized Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), strengthened Medicare-Medicaid integration requirements, and directed the establishment of procedures to unify Medicare and Medicaid appeals and grievance procedures to the extent feasible for D-SNPs beginning in 2021. On April 16, 2019, CMS finalized rules to implement these new statutory provisions.

All D-SNPs must have executed contracts with state Medicaid agencies, referred to as the "State Medicaid Agency Contract" (SMAC) or MIPPA contract, that meet a number of requirements, including Medicare-Medicaid integration requirements and, for some D-SNPs, unified appeals and grievance processes.

Additional Information for D-SNPs and States

Information about D-SNP Look-Alikes


Unified Appeals and Grievances

More information about D-SNPs can be found on the Medicare D-SNPs page.

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Page Last Modified:
10/05/2023 08:40 PM