D-SNP networks live at the intersection of Medicare and Medicaid. Blueprint handles both.
D-SNP is a Medicare Advantage Special Needs Plan — governed by CMS under 42 CFR Part 422 and filed through HPMS like any MA plan. But unlike standard MA, D-SNPs must also satisfy state Medicaid integrated care requirements and execute an Integrated Care Agreement with the state Medicaid agency. Blueprint scores both regulatory frameworks simultaneously and tracks ICA status as a dedicated workflow layer alongside contracting and credentialing.
The Challenge
Why D-SNP builds are more complex than standard MA
Two regulatory frameworks, one provider network
CMS evaluates your D-SNP network against HSD time-distance and ratio standards under 42 CFR 422.116. Your state Medicaid agency evaluates the same network against its integrated care access standards. Both reviews happen — and both must pass before your plan can operate.
Dual-eligible populations require a different provider mix
Dual-eligible beneficiaries have significantly higher rates of behavioral health conditions, chronic illness, and long-term care needs. Behavioral health, LTSS, HCBS, and community-based service providers are required for D-SNP adequacy — and are the hardest to source in rural and semi-rural counties.
ICA execution and FIDE/HIDE requirements add a contracting layer standard MA doesn't have
Every D-SNP plan must execute and maintain an Integrated Care Agreement with the state Medicaid agency — separate from provider contracting. FIDE-SNP and HIDE-SNP designations carry additional alignment requirements. No generic CRM has a workflow for this.
The Solution
How Blueprint handles D-SNP
Dual regulatory scoring engine
Blueprint applies CMS HSD adequacy standards and state Medicaid D-SNP access standards to the same provider set simultaneously. One unified gap report — not two separate analyses you have to reconcile the week before deadline.
ICA and FIDE/HIDE tracking
ICA execution with the state Medicaid agency is tracked as a distinct workflow alongside provider contracting — with its own status, milestone dates, and document log. FIDE-SNP and HIDE-SNP alignment requirements are flagged separately from standard MA obligations.
D-SNP provider prioritization
Blueprint's recruitment priority map surfaces behavioral health, LTSS, HCBS, and community-based service providers first — the specialty mix D-SNP adequacy requires, and that a standard MA recruiting playbook won't prioritize.
Purpose-built
Features built for D-SNP
- Simultaneous CMS MA + state Medicaid scoring
- ICA status tracking with milestone dates
- FIDE-SNP and HIDE-SNP designation flags
- Behavioral health adequacy by county
- LTSS and HCBS provider tracking
Live adequacy score
Updated in real time as providers are added
Regulatory context
D-SNP Adequacy Standards — dual regulatory scoring in Blueprint
D-SNP plans are Medicare Advantage plans governed under 42 CFR Part 422 — which means the full CMS MA adequacy framework applies: 22 HSD specialty types, time-distance thresholds by county urbanicity class, and provider-to-member ratio requirements. But D-SNPs also carry state Medicaid network obligations under each state's integrated care contract. Blueprint scores your D-SNP network against both regulatory frameworks in a single pass. As your team contracts providers, Blueprint checks adequacy against the CMS HSD file and your state's D-SNP access standards simultaneously — so you're never reconciling two separate gap analyses at deadline. FIDE-SNP and HIDE-SNP alignment requirements are tracked as a separate compliance layer.
See how Blueprint handles your LOBIllustrative scenario
“For a D-SNP expansion, Blueprint shows both MA and Medicaid gaps on the same screen — so there's no reconciling two separate gap analyses at deadline.”
Illustrative scenario based on a common network-build situation — not an actual customer. Blueprint is a new product.
FAQ
Common questions
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See Blueprint on your D-SNP build.
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