SNP Model of Care (MOC)

Required Elements of an SNP MOC

As defined by section 1859f7 of the Social Security Act, every SNP must have a Model of Care (MOC) approved by the Centers for Medicare & Medicaid Services (CMS).

Excluded Element

The following is not included in an SNP MOC:

• Special Needs Plans (SNPs) are either HMO or PPO plans.

Additional Elements

In addition to the required elements, an SNP MOC must include the following:

• A specific population
• Integral components of the model of care
• All elements in this standard depend on the specific population

Review and Approval

SNPs must submit their MOCs annually for review and approval by CMS, according to section 1859f5Biv of the Act.

Assessment

The National Committee for Quality Assurance (NCQA) assesses the MOC from each SNP according to detailed CMS scoring guidelines.