On November 13, 2008, CMS announced the 15 chronic conditions certain Medicare Advantage special needs plans (SNPs) must use to identify the beneficiary populations eligible for enrollment, beginning in 2010. SNPs are a type of MA plan that serve only beneficiaries living in institutions, eligible for both Medicare and Medicaid, or living with severe or disabling chronic conditions. For SNP purposes, chronic conditions are defined as being medically complex, substantially disabling or life threatening, having a high risk of hospitalization or other adverse outcomes, and requiring a specialized delivery system across domains of care. The specific clinical conditions identified as meeting this definition are: chronic alcohol and other drug dependence; certain autoimmune disorders; cancer excluding pre-cancer conditions; certain cardiovascular disorders; chronic heart failure; dementia; diabetes mellitus; end-stage liver disease; end-stage renal disease requiring dialysis (all modes of dialysis); certain severe hematologic disorders; HIV/AIDS; certain chronic lung disorders; certain chronic and disabling mental health conditions; certain neurologic disorders; and stroke.