CMS releases proposed 2026 payment updates for Medicare Advantage, Part D

The Centers for Medicare & Medicaid Services Jan. 10 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
News
The Centers for Medicare & Medicaid Services April 7 released finalized payment rates for calendar year 2026 Medicare Advantage and Part D plans. Payments…
Headline
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The…
Headline
The AHA March 11 shared ways Congress could better support patient access to post-acute care in comments for a hearing held by the House Committee on Ways and…
Headline
A new AHA report highlights how certain practices by Medicare Advantage plans are increasing rural hospitals' vulnerabilities and threatening access to care in…
Headline
An analysis by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding…
Headline
The AHA Jan. 27 voiced support for the Centers for Medicare & Medicaid Services proposed rule on policy and technical changes to Medicare Advantage and…