What does CMS actually review, and when do you know you’re approved?
Two parallel reviews through the summer: bid desk review (does the pricing work) and readiness review (can you actually operate). Contract execution typically lands in late summer, before the September ANOC cycle.
Approval is not guaranteed — CMS can deny an application or decline to execute a contract.
What this stage actually is
The uncomfortable stage. You must build the operational stack over the summer as if you are approved, without knowing that you are. There is no way to sequence around this.
What you must do
- Work the bid desk. Respond to CMS questions and resubmit corrected BPT/PBP within CMS’s windows.
- Pass readiness review. CMS assesses enrollment, claims, appeals and grievances, call centre, provider directory accuracy and the compliance programme.
- Execute the contract (and Part D addendum) when CMS extends it.
- Confirm final approved plan IDs, service area, premiums and benefits — these flow into Medicare Plan Finder for AEP.
Key dates
| What | When | Date status |
|---|---|---|
| Bid review and negotiation | Jun–Aug | pattern |
| Readiness review | Summer | pattern |
| Contract execution | Typically by early-to-mid September | pattern |
About the dates on this page. CY2027 dates are published CMS facts. CY2028 dates marked statutory are fixed by regulation. Dates marked projected are the pattern from the CY2026 and CY2027 cycles — CMS has not published them yet, and we relabel them the day it does. How we label data and dates →
CMS forms, systems and references
- Medicare Managed Care Manual, Chapter 11
- Part C Bid Review Memorandum
- CMS readiness review checklists
- 42 CFR Part 422 Subpart K
Common mistakes
- Call centre and provider directory findings — the two most common readiness review failures, and both are fixable in advance.
- No denial contingency. Decide now what happens to network contracts and hired staff if CMS says no.
- Going quiet. CMS questions carry response windows; a slow reply becomes a finding.
Tips for success
- Run a mock readiness review in July against the published checklist.
- Load and validate provider directory data early — accuracy findings are volume problems, not policy problems, and volume takes time.
- Keep the marketing production calendar moving in parallel; October 1 does not wait for your contract signature.
The data you need for this stage
- Policy impact — enforcement posture and readiness-review changes
So what / Now what
Approval arrives weeks before you must be operationally live. The plans that handle this stage well are the ones that treated readiness as a build project starting in the spring, not a review event in the summer.
- Book the mock readiness review into the plan now, for July of your application year.
- Write the denial contingency before you sign network contracts.
- Track CMS enforcement and readiness posture in Policy impact.
Provenance — sources and date status
- Source files
- Medicare Managed Care Manual, Chapter 11; CY2027 MA and Part D Final Rule; CY2027 Rate Announcement; CY2027 Part D Bidding Instructions
- Vintage
- CY2027 cycle published; CY2028 cycle not yet posted by CMS
- Last updated
- July 24, 2026
- Refresh cadence
- At each CMS cycle milestone (application posting, Advance Notice, Rate Announcement, final rule)
- Method
- CY2027 dates are transcribed from CMS materials. CY2028 dates are either statutory (bid = first Monday in June; Rate Announcement = first Monday in April; ANOC receipt = Sep 30; marketing start = Oct 1; AEP = Oct 15–Dec 7) or projected from the CY2026 and CY2027 cycle pattern.
- Known limitations
- Projected dates are not CMS commitments and must be confirmed against the CMS application page and HPMS memos when the CY2028 cycle opens. Network adequacy standards and application procedures change between cycles — verify current-cycle instructions rather than reusing prior-year guidance.
← Stage 3: Bid development and submission · Stage 5: Marketing and your first AEP → · All seven stages