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US · guidance

CMS Pub. 100-16, ch. mc86c16b, § 20.2.3

Relationship to State Medicaid Agencies (42 CFR 422.107(b))

activein force · 2026-08-25 – presentas-observed

Pursuant to section 164(c)(4) of MIPPA, state Medicaid agencies are not required to enter into

contracts with MAOs with respect to D-SNPs. In addition to the SMAC, the MAO must still meet

all CMS application requirements, including that the organization be organized and licensed under

state law as a risk-bearing entity eligible to offer health insurance or health benefits coverage in the

state, to have an MA contract and to offer a D-SNP.

History

(Rev. 129, Issued: 08-11-23, Effective: 08- 11- 23; Implementation: 08- 11- 23)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
8b3892f75e36cae7def848988a6c6ddc49aa2514ac3f419af2966a4c3ae20721
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