What’s happening: CHA submitted comments in response to the Centers for Medicare & Medicaid Services’ (CMS) proposed policy and technical changes to Medicare Advantage (MA) and Part D programs for contract year 2026.
What else to know: Finalization of the proposed rule is expected in April — in time for MA plans to bid to CMS and offer MA products for plan year 2026. The rule, once finalized, will take effect Jan. 1, 2026.
CHA addresses several insurer accountability topics in the letter and supports:
- Increased oversight of certain MA plan practices that can inappropriately delay or deny access to care
- Stronger enforcement of existing MA regulations to protect beneficiaries and ensure patients have equitable access to Medicare-covered services, including inpatient hospital admissions and post-acute care
- More robust scrutiny and regulatory protections regarding MA plan use of internal coverage criteria and compliance with the two-midnight benchmark
CHA thanks members for their input, which informed comments.
