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.