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will become the 2026 measure-level CAHPS Star Ratings. The 2027 CAHPS measure-level Star Ratings would be the better of the 2027 and 2026 CAHPS measure-level Star Ratings.

Table VI-4 lists the emergency areas affected by emergency declarations first issued in 2025, as defined in section 1135 of the Act, and the exercise of the Secretary’s authority under section 1135 of the Act that apply for MA and PDP CAHPS adjustments for the 2026 Star Ratings.

Table VI-4. List of Section 1135 Waivers Issued in Relation to the FEMA Major Disaster Declarations that Apply for MA and PDP CAHPS Adjustments for the 2026 Star Ratings Section 1135 Waiver Date Issued Waiver or Modification of Requirements Under Section 1135 of the Social Security Act FEMA Incident Type Affected State Incident Start Date January 10, 2025 Wildfires Wildfires and Straight-line Winds California January 7, 2025

Table VI-5 lists the states and territories with Individual Assistance designations from the FEMA major disaster declarations that apply for MA and PDP CAHPS adjustments for the 2026 Star Ratings.

Table VI-5. Individual Assistance Counties and County-Equivalents in FEMA Major Disaster Declared States/Territories that Apply for MA and PDP CAHPS Adjustments for the 2026 Star Ratings FEMA Declaration State FEMA Individual Assistance Counties or County- Equivalents DR-4856-CA California Los Angeles Section G. Changes to Existing Star Ratings Measures for the 2026 Measurement Year and Beyond CMS solicits feedback on new measure concepts as well as measure updates through the annual Advance Notice and Rate Announcement process. We also provide advance notice regarding measures considered for implementation as future Star Ratings measures. As codified at §§ 422.164(c)(2)(4), 423.184(c)(2)(4), 422.164(d)(2), and 423.184(d)(2), new measures and measures with substantive specification changes must be added or updated through rulemaking and must remain on the display page for at least two years prior to becoming a Star Ratings measure. CMS uses the Advance Notice and Rate Announcement process to announce non- substantive specification changes as described at §§ 422.164(d)(1) and 423.184(d)(1) and to remove measures as described at §§ 422.164(e) and 423.184(e).