On November 26, 2024, the Centers for Medicare and Medicaid Services (CMS) released the “CY2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly”. The deadline to submit comments is January 27, 2025.
The Proposed Rule includes numerous suggested regulations for the contract year 2026 and beyond affecting Part D, provider network requirements, minimum loss ratio calculations, and plan determinations of coverage applicability.
Please note that this summary is primarily focused on the financial and actuarial aspects of the Proposed Rule and is not intended to be a comprehensive description of all portions of the Rule.
