Today, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2026 Rate Announcement for the Medicare Advantage and Medicare Part D Prescription Drug Programs. This announcement finalizes payment policies for these programs and follows the CY 2026 MA and Part D final rule released on April 4. These updates are part of CMS's routine annual adjustments to the MA and Part D programs.
The CMS aims to protect beneficiaries and taxpayers from waste, fraud, and abuse while ensuring access to high-quality, affordable healthcare through Medicare Advantage. By finalizing these payment policies, CMS intends to maintain efficient access to critical services within Medicare Advantage.
Government payments to MA plans are expected to increase by an average of 5.06% from 2025 to 2026. This rise is a result of a higher effective growth rate, now at 9.04%, compared to the previous estimate of 5.93%. The change is due in part to additional data on fee-for-service expenditures that were not included in earlier estimates.
In CY 2024, CMS began a phased approach to remove medical education costs related to services received by MA enrollees from historical and projected expenditures. For CY 2026, this adjustment will be fully implemented.
Additionally, CMS is completing a three-year phase-in of improvements to the MA risk adjustment model that began with CY 2024. These measures aim to expand access to affordable care while safeguarding against waste and abuse.
CMS also released Final CY 2026 Part D Redesign Program Instructions detailing changes in the Part D drug benefit for CY 2026.
Further details can be found in the full announcements available on CMS's website.
Information from this article can be found here.
