The Medicare Improvement for Patients and Providers Act of 2008 (MIPPA), enacted July 15, 2008, has implications not only for Medicare Advantage Special Needs Plans (SNPs), but also for states. This CHCS Policy Update provides an overview of the SNP-related provisions contained in the legislation. In addition, it outlines potential implications for Medicaid agencies that have developed (or are interested in developing) an integrated care program for dual eligibles, and for states in which SNPs currently operate. The Centers for Medicare and Medicaid Services recently issued an interim final rule with comment period for these provisions. The deadline for comments is November 16th (see the CHCS update for CMS web link for comments).