CMS Pub. 100-16, ch. mc86c16b, § 50.3

A crosswalk is the movement of enrollees from one plan (or plan benefit package (PBP)) to another

plan (or PBP) under a contract between the MA organization and CMS. To crosswalk enrollee from

one PBP to another is to change the enrollment from the first PBP to the second. Except as specified

in 42 CFR 422.530(c)(2), (3), and (4)(ii), MA organizations may not crosswalk enrollees from one

contract to another contract. MA organizations may not crosswalk enrollees from one SNP type to a

different SNP type.

In addition, MA organizations must comply with renewal and nonrenewal rules in 42 CFR §§

422.505 and 422.506 in order to complete plan or PBP crosswalks. Please refer to 42 CFR §

422.530 for the standard crosswalk rules applicable to all MA plans, including all SNPs. Please also

refer to the annual End-of-Year Enrollment and Payment Systems Processing Information memo

released each year for details related to the Medicare Advantage and Prescription Drug (MARx)

System Transaction Processing and Rollover and Terminating Plan MARx Transaction Processing

instructions. The tables below outline the crosswalk scenarios for D-SNPs, C-SNPs, and I-SNPs.

Table 6: C-SNP Crosswalk Scenarios

Activity Regulatory Authority Requires

Crosswalk

Exception

Allows Movement

across Contracts

HPMS Plan

Crosswalk

Renewing C-SNP

with one chronic

condition that

transitions eligible

enrollees into

another C-SNP with

a grouping that

contains that same

chronic condition.

Non-renewing C-SNP with one

chronic condition

that transitions

eligible

enrollees into

another C-SNP with

a grouping that

contains the same

chronic condition.

42 CFR

422.530(b)(2)(i)(A)

42 CFR

422.530(b)(2)(i)(B)

42 CFR

422.530(b)(2)(i)(C)

No No. Except as

provided by §

422.530(c), crosswalks

are prohibited between

different contracts or

different plan types

(for example,

HMO to PPO or from

one type of SNP to a

different type of SNP).

Several types of

exceptions are

addressed elsewhere in

Tables 6 through 8.

During Bid

Submission

window, select Plan

Crosswalk

Designation:

Consolidated Plan

Renewal

Non-renewing C-SNP with a

grouping that is

transitioning

eligible enrollees

into a different C-SNP if the new

grouping contains

at least one

condition that the

prior plan

contained.

Renewing C-SNP

with a grouping of

multiple conditions

that is transitioning

eligible enrollees

into another C-SNP

with one of the

chronic conditions

from that grouping.

42 CFR 422.530(c)(5) Yes No. This is not one of

the exceptions

permitting a crosswalk

across contracts.

During Bid

Submission

window, select

Consolidated

Renewal Plan

Table 7: D-SNP Crosswalk Scenarios

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

Guidelines HPMS Plan

Crosswalk

Renewing D-SNP with a

multi-state

service area that

reduces its

service area and

moves

enrollees who

are no longer in

the service

area of the

renewing D-SNP to one or

more renewing

D-SNPs (for

42 CFR

422.530(c)(3)

Yes Yes Movement is

permitted if the

enrollees are eligible

for the

receiving D-SNPs

and CMS

determines the

crosswalk is

necessary to

accommodate

changes to the

contracts between the

state and D-SNP

under 42 CFR

422.107.

During

Crosswalk

Exception

Submission

window,

select

Crosswalk

Exception

Request

Type 2 –

Renewing

D-SNP with

service area

change,

includes

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

Guidelines HPMS Plan

Crosswalk

which the

enrollees are

eligible) offered

under the same

parent

organization.

RPPO to

LPPO

A D-SNP in a

RPPO that nonrenews to create

state-specific

local PPOs in

its

place to

accommodate

state contacting

efforts in the

service area and

moves

enrollees who

are no

longer in the

service area to

one or more

renewing D-SNPs offered

under the same

parent

organization.

42 CFR

422.530(c)(3)

Yes Yes Movement is

permitted if the

enrollees are eligible

for the

receiving D-SNPs

and CMS

determines the

crosswalk is

necessary to

accommodate

changes to the

contracts between the

state and D-SNP

under 42 CFR

422.107.

During

Crosswalk

Exception

Submission

window,

select

Crosswalk

Exception

Request

Type 2 –

Renewing

D-SNP with

service area

change,

includes

RPPO to

LPPO

Renewing D-SNP has

another new or

renewing

D-SNP and the

two D-SNPs are

offered to

different

populations, and

moves enrollees

who are

42 CFR

422.530(c)(4)(i)

Yes No Movement is

permitted if the

enrollees meet the

eligibility criteria for

the new or renewing

D-SNP and

CMS determines it is

in the best interest of

the enrollees to move

to

the new or renewing

D-SNP in order to

During

Crosswalk

Exception

Submission

window,

select

Crosswalk

Exception

Request

Type 3 –

Change in

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

Guidelines HPMS Plan

Crosswalk

no longer

eligible for their

current D-SNP

into the

promote access and

continuity of

D-SNP

populations

other new or

renewing D-SNP offered by

the same MA

organization.

care for enrollees

relative to the absence

of a crosswalk

exception.

MA

organization

creates a new

D-SNP-only MA

contract when

required by a

state as

described in 42

CFR

422.107(e),

eligible

enrollees may

be moved

from the

existing D-SNP

(that is non-renewing or

having its

eligible

population

newly restricted

by a state to

achieve

exclusively

aligned

enrollment) to a

D-SNP

offered under

the D-SNP-only

contract.

42 CFR

422.530(c)(4)(ii)

Yes Yes The new D-SNP-only

contract is approved

and permitted by

CMS

under § 422.107(e)

and movement must

be to the same plan

type operated by the

same parent

organization.

During

Crosswalk

Exception

Submission

window,

select

Crosswalk

Exception

Request

Type 9 –

MA-PD

with a D-SNP

transition to

D-SNP only

contract

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

Guidelines HPMS Plan

Crosswalk

When one or

more MA

organizations

that share a

parent

organization

seek to

consolidate D-SNPs in the

same service

area down to a

single PBP

under one MA-PD contract to

comply with the

requirements at

42 CFR

422.514(h) and

422.504(a)(20).

42 CFR

422.530(c)(4)(iii)

Yes Yes Available beginning

in 2026 for CY 2027.

Movement must be to

the same plan type

and operated under

by the same parent

organization

During

Crosswalk

Exception

Submission

window,

select

relevant

Crosswalk

Exception

Request

Table 8: I-SNP Crosswalk Scenarios

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

HPMS Plan

Crosswalk

Renewing Institutional

SNP that transitions

enrollees to an

Institutional/Institutional

Equivalent SNP

42 CFR

422.530(b)(2)(ii)(A)

No No During Bid

Submission

window, select

Consolidated

Renewal Plan

Renewing Institutional

Equivalent SNP that transitions

enrollees to an Institutional/

Institutional

42 CFR

422.530(b)(2)(ii)(B)

No No During Bid

Submission

window, select

Equivalent SNP

Consolidated

Renewal Plan

Renewing Institutional/

Institutional Equivalent SNP

that transitions eligible

42 CFR

422.530(b)(2)(ii)(C)

No No During Bid

Submission

window, select

Activity Regulatory

Authority

Requires

Crosswalk

Exception

Allows

Movement

across

Contracts

HPMS Plan

Crosswalk

enrollees to an Institutional

SNP

Consolidated

Renewal Plan

Renewing Institutional/

Institutional Equivalent SNP

that transitions eligible

enrollees to an Institutional

Equivalent SNP

42 CFR

422.530(b)(2)(ii)(D)

No No During Bid

Submission

window, select

Consolidated

Renewal Plan

Nonrenewing

Institutional/Institutional

Equivalent SNP that transitions

eligible enrollees to another

Institutional/Institutional

Equivalent SNP

42 CFR

422.530(b)(2)(ii)(E)

No No During Bid

Submission

window, select

Consolidated

Renewal Plan