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One Care Transition Planning

Transitioning One Care from Medicare-Medicaid Plans (MMPs) to Dual Eligible Special Needs Plans (D-SNPs)

Table of Contents

Transition Background

In Spring 2022, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule “Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.” The Final Rule was published in the Federal Register on May 9, 2022 (2022-09375.pdf (govinfo.gov).

The Final Rule included certain flexibilities for Dual Eligible Special Needs Plans (D-SNPs) and a transition for Medicare-Medicaid Plans (MMPs) from Demonstration to D-SNP authority. One Care provides comprehensive integrated care to dual eligible adults with disabilities (ages 21-64 at enrollment) through MMPs. As the Rule requires, EOHHS is planning to transition One Care to a D-SNP platform effective January 1, 2026. The process for developing the Transition Plan in consultation with stakeholders is described in the Initial Transition Plan submitted to CMS.

For reference, see EOHHS comments submitted to CMS on the proposed rule on March 7, 2022.

Initial Plan for Transition Process

September 30, 2022

The initial Transition Plan lays out the process EOHHS expects to use to determine the structural, policy, and operational elements of its Transition. This plan will be considered a living document that will be updated and expanded based on the feedback received from stakeholders and CMS. EOHHS is committed to an engagement process with a wide array of stakeholders to promote collaborative discussion on the planning and implementation as it begins its transition planning process.

Additional Resources

Stakeholder Engagement

Please visit this page for upcoming public meetings and information related to MassHealth's ongoing engagement with various Stakeholder groups.

Additional Resources

Plan Procurement for 2026

Date published: September 30, 2022
Last updated: May 31, 2023

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