loading…
loading…
loading…
36
the updates and the continued planned phase-in of the risk adjustment model proposed in the CY 2026 Advance Notice are technical, data-driven, and clinically-based updates that improve the accuracy of payments to MA organizations, as required under the statute governing the MA program. Additionally, CMS acknowledges that the Advance Notice and Rate Announcement documents are highly technical, given their focus on methodological updates to the MA capitation and payment rates. Each year, we also release a Press Release and Fact Sheet that summarize key proposed updates, and the impact of those changes, to support the public’s understanding. Throughout the Rate Announcement, CMS provides links to additional resources as much as possible, so readers can refer to the primary sources of information that can provide more specific detail than can be included in the Rate Announcement itself. Finally, CMS thanks the commenter for expressing their concern that MA plans use deceptive marketing schemes and aggressive and inappropriate care denials but notes that these topics are outside the scope of the Rate Announcement. Section B. Estimates of the MA and FFS Growth Percentages for CY 2026 Phase-in of Technical Adjustment to the non-ESRD USPCC Baseline Regarding MA-Related Medical Education Expenses Comment: A commenter expressed support for CMS’ efforts to remove MA-related medical education payments from the non-ESRD FFS USPCC estimates, CMS’ ongoing efforts to improve the accuracy of rates, and the transparency of those efforts. Response: We appreciate the support. Comment: A large number of commenters requested that CMS consider pausing the continued phase-in of the technical adjustment for CY 2026, extending the phase-in period (e.g., apply 75 percent of the technical adjustment for CY 2026 and 100 percent in CY 2027), in order to further mitigate the impact of the technical adjustment and to allow further evaluation of the impact of the policy to ensure alignment with the Administration’s priorities and goals for MA beneficiaries. Several of these commenters suggested that implementing the remaining 48% of the adjustment over two years (i.e., CYs 2026 and 2027), rather than as a one-time correction in CY 2026, would more reasonably align with the initial phase-in schedule of approximately 33% annual impact put forth in the CY 2024 Rate Announcement. Several commenters indicated that increasing the adjustment from 52% to 100% for CY 2026 would not provide an adequately gradual phase-in. Response: We appreciate the concerns raised by the commenters. We are finalizing the completion of the three-year phase-in schedule as proposed in the CY 2026 Advance Notice by applying 100 percent of the medical education technical adjustment for CY 2026. Completing