Free Network Build Assessment
Take it freeMedicare Advantage Open Enrollment Period runs October 15 – December 7. Members choose or switch plans based on your network. For your network to be compliant, CMS network adequacy filings must be complete months earlier — typically by June or July.
From CMS draft guidance in January to the plan year kick-off on January 1st, here is every critical milestone in the MA calendar.
CMS releases draft HPMS guidance and updates to time/distance standards for the upcoming plan year.
CMS MA Call Letter confirms network adequacy standards for the upcoming plan year — final requirements locked.
Network adequacy filing window opens in HPMS. Plans begin uploading provider rosters and documentation.
Typical deadline for CMS network adequacy submissions. Exact date varies by plan year — verify in HPMS.
CMS conducts adequacy review. Gap notices issued for plans with deficiencies by county or specialty.
Plans receiving gap notices must remediate deficiencies within the corrective action window — weeks, not months.
CMS bid approval and plan year finalization. Network must be locked and fully contracted.
OEP starts — Medicare-eligible members begin selecting and switching plans based on networks and benefits.
Enrollment decisions are locked. Your contracted, credentialed network determines member access for the full plan year.
Contracted network must be fully operational — credentialed providers live in directory and accessible to members.
Exact dates vary by plan year. Verify current year deadlines in your HPMS system and CMS MAPD guidance.
Network adequacy is not just a compliance checkbox. During OEP, it is your most visible competitive attribute.
During OEP, Medicare-eligible members compare plans. Your network — specifically who is in-network — is a primary selection factor for members with established care relationships.
Plans that fail network adequacy review may face enrollment restrictions during OEP. A gap notice received in August leaves only weeks to remediate before OEP begins.
Health plans with broader, more stable networks win more OEP enrollments. A compliant network is not just a regulatory requirement — it is a competitive advantage.
To hit a June filing deadline, your kickoff needs to happen in February. Here is what each phase looks like.
Service area, LOB, and county list confirmed. County leads assigned. Weekly adequacy cadence established.
County-by-county adequacy gap analysis complete. Specialty shortfalls identified by county.
Must-have providers ranked by county and specialty. Tier-1 list exported to outreach team.
LOIs and outreach packets sent to all Tier-1 providers. Pipeline tracking active in Blueprint CRM.
Credentialing packets submitted for all providers who returned signed LOIs. DCEs flagged for expedited review.
Fee schedule negotiations active. 50% of required contracted providers should have executed agreements.
Final contract signatures collected. Network locked — no new additions without re-running adequacy analysis.
Final adequacy re-run on fully contracted and credentialed roster. Supporting documentation package assembled.
Provider network files submitted to CMS HPMS. Submission confirmed and documented.
These are not edge cases. They show up on nearly every compressed-timeline build.
Most plans should start in January or February. Plans that wait until April are immediately in compressed-timeline territory with high gap notice risk.
Credentialing takes 60–90 days. Plans that execute contracts in April but do not start credentialing until then often have un-credentialed providers at filing time.
Rural counties with one specialist are ticking time bombs. When that provider leaves or gets decredentialed mid-build, the county fails. Identify and mitigate these early.
Plans using spreadsheets often discover adequacy gaps the week before filing. By then, there is no time to close them through contracting. Real-time adequacy scoring during the build changes this completely.
Every feature in Blueprint — from gap analysis to outreach to credentialing tracking — maps to the milestones between your kickoff date and your CMS filing.
Live adequacy scoring
Updated every time a provider contracts or credentials.
County-level milestone tracking
See which counties are on track and which are at risk.
Outreach campaign automation
LOI send, tracking, and follow-up all in one system.
Credentialing timeline projection
Know in February how your credentialing pipeline will look in May.
Gap notice response toolkit
If you receive a notice after filing, Blueprint gives you the tools to close gaps fast.
OEP-ready provider directory
Your contracted, credentialed roster is always current for directory submission.
Free tools for Medicare Advantage network development teams.
Blueprint helps MA plan network teams run a compliant, on-time annual build — year after year.
No commitment. Personalized to your plan and service area.