CMS proposes Medicare Advantage payment hike in 2026

Healthcare DIVE January 13, 2025
Rebecca Pifer

The Biden administration’s last MA rule is a boon for insurers, though it remains to be seen how the incoming Trump administration might put its stamp on the regulation before it’s finalized.

Dive Brief:

• The Biden administration’s last word on the Medicare Advantage program gives health insurers something to look forward to in 2026. On Friday, regulators proposed a 4.3% hike on average to MA reimbursement, which would result in $21 billion in additional payments to insurers next year.
• The rule increases the average benchmark payment to MA plans by 2.2%, with insurers’ coding for member sicknesses making up the rest of the projected payment jump. It’s the largest increase to the MA benchmark in several years.
• The rule...

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