2027 Medicare Advantage Final Rule, Rate Released

CMS released the 2027 Medicare Advantage and Part D Final Rule April 2, that will take effect Jan. 1. The final rule, eliminates the prescription drug coverage gap, lowers the annual beneficiary out of pocket cap, ends cost sharing in the catastrophic phase, and formally implements the Medicare Part D Manufacturer Discount Program. ACR^® created a summary of relevant policies, including changes to the Star Ratings program and outlines changes that result from an executive order issued by the White House aimed to reduce duplicative and burdensome regulatory requirements (E.O. 14192).

CMS released the 2027 Medicare Advantage and Part D Rate Announcement April 6. The notice sets how much CMS will pay plans and finalizes proposals from an Advance Notice released in January.

The rate announcement updates benchmarks, capitation rates, risk adjustment models, coding patterns and payment impacts from 2026 Star Ratings. The Star Ratings program is a CMS system that rates MA and Part D plans from 1 to 5 stars based on quality, performance, and member experience to help beneficiaries compare plans and to determine bonus payments to plans. CMS projects a net average payment increase of 2.48%, or more than $13 billion in additional Medicare Advantage payments in 2027.

For more information or if you have questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst.