CMS releases proposed 2026 payment updates for Medicare Advantage, Part D
The Centers for Medicare & Medicaid Services Jan. 10 proposed a 4.3% payment increase to Medicare Advantage plans for calendar year 2026, amounting to approximately $21 billion. CMS also proposed to complete its implementation of a three-year phase-in of changes to the MA risk adjustment model and growth rate calculation related to medical education costs in addition to other technical improvements. In addition, out-of-pocket prescription drug costs for individuals with Medicare Part D will be capped at $2,100 in 2026.
CMS is accepting comments through Feb. 10 on the advance notice of proposed changes. The agency expects to publish the final 2026 rate announcement by April 7.
Related News Articles
Headline
The Centers for Medicare & Medicaid Services April 6 released the Medicare Advantage and Part D Rate Announcement for calendar year 2027. The rate…
Headline
The Centers for Medicare & Medicaid Services April 2 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription…
Headline
The Centers for Medicare & Medicaid Services March 30 announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of…
Headline
CMS accepting comments on data collection requirements for Medicare Advantage plans, Part D sponsors
The Centers for Medicare & Medicaid Services is seeking comments by May 11 on its proposed revisions to data reporting requirements for Medicare Advantage…
Headline
The Joint Economic Committee March 10 released a report that found Medicare Part B premiums rose last year due to Medicare Advantage overpayments. The…
Headline
A JAMA study published Feb. 18 found that 10% of Medicare Advantage beneficiaries — approximately 2.9 million — have needed to find other health coverage for…