Deadlines for Medicare Advantage Plan Applications Announced

(June 25, 2024) The Department of Health (DOH) has released deadlines for the submission of applications to the State to establish new Medicare Advantage plans and expand Medicare Advantage plan service areas for Medicare Coverage Year 2026. Approval by DOH is required to offer a Medicare Advantage product or expand a service area. Most notably, existing Article 44 managed care organizations certified under Public Health Law Article 44 that wish to establish a new Medicare Advantage type line of business must submit their applications to DOH by Aug. 1, 2024. Existing managed care organizations that wish to expand their Medicare Advantage offerings to a new county or a new Medicare Advantage plan type must apply by Nov. 1, 2024. These deadlines apply to all Medicare Advantage plan types, including Medicaid Advantage Plus (MAP), Integrated Benefits for Dually Eligible Enrollees (IB-Dual), Dual Eligible Special Needs Plan (D-SNP), Chronic Condition Special Needs Plan (C-SNP), Institutional Special Needs Plan (I-SNP), and Institutional Equivalent Special Needs Plan (IE-SNP).

More information and additional deadlines are available here. 

DOH has also notified plans that the updated due dates include changes regarding Centers for Medicare and Medicaid Services (CMS) enrollment sanction authority that will cease beginning with Calendar Year 2026 for MAP and IB-Dual plans. According to the Department, a health plan completing the 2026 State Medicaid Agency Contract (SMAC) with a pending MAP, IB-Dual, or service area expansion application must be approved by the State and ready to begin enrollment on Jan. 1, 2026. Failure to secure approval may result in CMS considering the D-SNP application withdrawn.

Questions may be submitted to DOH here.

Contact: Karen Lipson, klipson@leadingageny.org