In April 2024, the Centers for Medicare & Medicaid Services (CMS) released its contract year 2025 Medicare Advantage and Part D final rule.1 That final rule included new provisions at 42 CFR §422.514(h) that are designed to simplify enrollment options for dually eligible individuals and promote alignment of Medicare and Medicaid coverage for enrollees in dual eligible special needs plans (D-SNPs) that have affiliated Medicaid managed care organizations (MCOs). Those new rules, which take effect in 2027 and 2030, apply to Medicare Advantage (MA) organizations offering D-SNPs that: (1) operate in the same or overlapping service areas as Medicaid MCOs offered by the same parent organization as the D-SNPs, and (2) enroll full benefit dually eligible (FBDE) individuals. In addition to the frequently asked questions (FAQ) document issued by CMS, the Integrated Care Resource Center (ICRC) has developed this tip sheet to help states understand these new rules and work with affected D-SNPs to ensure compliance. It provides an overview of the rules at 42 CFR 422.514(h), illustrative examples and options for D-SNP compliance, and specific action steps for states.