What’s happening: On Jan. 10, the Centers for Medicare & Medicaid Services (CMS) issued advance notice of proposed capitation rate and payment updates for Medicare Advantage (MA) and Part D plans for calendar year (CY) 2026.
What else to know: The final 2026 rate announcement is expected by April 7.
In the advance notice, CMS proposes a 4.33% payment increase to MA plans, or more than $21 billion, from 2025 to 2026. CMS also proposes to complete the implementation of a three-year phase-in for an MA risk adjustment model and growth rate calculation related to indirect and direct medical education costs.
Additional details are available in a fact sheet.
