CMS issues final rule on CY 2026 policy and technical changes to Medicare programs 

The Centers for Medicare & Medicaid Services Sept. 18 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly for contract year 2026. Yesterday’s final rule follows one released in April on other changes for MA and prescription drug programs. In the latest final rule, CMS finalized a requirement aimed at increasing beneficiary access to provider directory data in the CMS Medicare Plan Finder platform. 

Also under the new policy, MA plans will be required to submit MA provider directory data to CMS for online publication. If an MA plan becomes aware of a data change, the MA plan must submit updated data to CMS 30 days from the date the plan became aware of the change. MA plans will have to attest annually to the accuracy of provider directory data. CMS declined to finalize a requirement for MA plans to attest that their MA provider directory data are consistent with data submitted to CMS to demonstrate network adequacy compliance. 

In a memo released concurrently with the final rule, CMS announced its intent to issue operational guidance that will include technical specifications for MA plans to comply with the new requirement, including the timeframe for beginning submission of data to CMS. The agency will solicit feedback on the forthcoming guidance.