CMS Releases Proposed 2026 MA Payment Policy Updates (SNF)

The Centers for Medicare and Medicaid Services (CMS) recently released the Calendar Year (CY) 2026 Advance Notice for Medicare Advantage and Part D that, when finalized, will update program payment policies. The proposed policies are projected to, on average, increase Medicare Advantage (MA) rates by 4.33% – over $21 billion – from 2025 to 2026. However, plan specific rates will vary because the projection factors in several other modifiers, including risk adjustment. 

The proposed update would complete the three-year phase-in of CMS’s revised payment formula, which includes an updated risk adjustment model and a technical update, aimed at preventing unnecessary payments while ensuring MA beneficiaries can continue to access the care they need.

The proposal updates the Part D payment methodology as part of the Inflation Reduction Act implementation and CMS drug price negotiation for the first 10 high-cost drugs starting in 2026. These changes are expected to lower costs for beneficiaries.  

By statute, the rate announcement must be finalized by the first Monday in April, which is April 7, 2025. Of note, it will be up to the Trump Administration to determine if it will make changes or finalize these proposed policies.