ACR Summarizes CY2026 Medicare Advantage Final Rule

The American College of Radiology® (ACR®) prepared a detailed summary of the Contract Year 2026 Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly final rule released April 4 by the Centers for Medicare and Medicaid Services (CMS).  

Notably, CMS did not finalize the proposal to establish new guardrails for artificial intelligence (AI) in the MA program to ensure services are provided equitably irrespective of delivery method or origin, whether from human or automated systems. CMS stated within the rule that they “acknowledge the broad interest in regulation of AI and will continue to consider the extent to which it may be appropriate to engage in future rulemaking in this area.”

Additional topics covered in the ACR summary include improving experiences for dually eligible enrollees, clarifying payment determinations made by MA organizations and risk adjustment updates.

The regulations outlined in the rule take effect June 3, and the provisions are applicable to coverage beginning Jan. 1, 2026 (except as otherwise noted within the rule). More information can be found in the agency’s fact sheet.

If you have questions, contact Kimberly Greck, ACR Senior Economic Policy Analyst.