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CMS Releases 2026 Advance Notice That Affects Payments to Medicare Advantage Plans
Jan. 15, 2025
The Centers for Medicare and Medicaid Services (CMS) released the 2026 Advance Notice for the Medicare Advantage (MA) and the Medicare Part D Prescription Drug Programs Jan. 10. The notice complements the 2026 MA and Part D proposed rule released in November; a fact sheet outlines the notice’s major provisions.
CMS proposes annual technical updates to MA and Part D in 2026 to ensure payments to plans are up to date and accurate. The agency also proposes to complete the three-year phase-in of improvements to its MA risk adjustment model, a process that calculates how much MA plans will pay providers based on a patient’s health conditions and expected medical costs. These improvements aim to provide predictability for plans and providers while implementing important updates and ensuring access to care for beneficiaries.
If finalized, CMS projects the proposed policies will result in a net increase of 4.33% (more than $21 billion) in MA payments to plans on average year-over-year in 2026. Eventually the net increase would affect provider payments since they get paid by MA plans, but exact amounts are unknown as they would vary by MA plan.
The Advance Notice is open for public comment through Feb. 10. CMS will publish the final rate announcement on or before April 7.
If you would like more information or have questions, contact Kimberly Greck, American College of Radiology® Senior Economic Policy Analyst.
CMS proposes annual technical updates to MA and Part D in 2026 to ensure payments to plans are up to date and accurate. The agency also proposes to complete the three-year phase-in of improvements to its MA risk adjustment model, a process that calculates how much MA plans will pay providers based on a patient’s health conditions and expected medical costs. These improvements aim to provide predictability for plans and providers while implementing important updates and ensuring access to care for beneficiaries.
If finalized, CMS projects the proposed policies will result in a net increase of 4.33% (more than $21 billion) in MA payments to plans on average year-over-year in 2026. Eventually the net increase would affect provider payments since they get paid by MA plans, but exact amounts are unknown as they would vary by MA plan.
The Advance Notice is open for public comment through Feb. 10. CMS will publish the final rate announcement on or before April 7.
If you would like more information or have questions, contact Kimberly Greck, American College of Radiology® Senior Economic Policy Analyst.
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