Becker's Healthcare January 26, 2026
CMS proposed its 2027 Medicare Advantage and Part D capitation rates and payment policies Jan. 26, putting forth a slowdown in payment growth after a $25 billion boost for 2026.
Five things to know:
- The proposed policies would result in a net average year-over-year payment increase of 0.09%, or roughly $700 million in MA payments for 2027. For 2026, CMS finalized a 5.06% increase worth $25 billion.
- CMS is proposing to exclude diagnosis information from “unlinked chart review records,” which are diagnoses not associated with a specific beneficiary encounter, from risk score calculations starting in 2027. The agency said plans that rely more heavily on unlinked chart reviews to report risk-adjustment eligible diagnoses will see a...
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