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In response to the alternatives presented by the commenter, we note that the 340B Remedy Rule (88 FR 77150) remedied the payment amounts made to 340B providers and facilities under FFS Medicare from 2018-2022 in two ways. First, under sections 1833(t)(14) and (t)(2) and, as necessary, section 1871(e)(2), CMS paid 340B-covered entities the difference between what they received for 340B-acquired drugs from 2018-2022 and what they would have received for 340B- acquired drugs if the 340B adjustment had not been in place (81 FR 77161). Second, under sections 1833(t)(14)(H), (t)(9)(B), and (t)(2)(E), and, as applicable, the equitable adjustment or common-law and inherent recoupment authorities, CMS unwound the $7.8 billion in payment increases for non-drug services and items in the 340B payment adjustment from 2018-2022 (82 FR 59482) in order to place providers in as close to a situation as they would have been if that policy never existed (88 FR 77174). CMS implemented the latter budget neutrality offset through a 0.5 percent reduction beginning in 2026 to the hospital outpatient prospective payment system conversion factor for hospitals enrolled in Medicare before January 2, 2018, over an estimated 16-year time period until a total of $7.8 billion is offset (88 FR 77181). Under the Medicare Advantage program, CMS provides a capitated prospective payment to Medicare Advantage organizations (MAOs) to provide coverage to enrollees, and the MA organizations pay the providers for this care. CMS calculated and paid CY 2018-2022 MA rates under the Advance Notice and Rate Announcement for those years, and those MA rates reflected the FFS policies as of the time they were finalized. The statutory and regulatory provisions of the MA program constitute a broader bidding and payment structure that is distinct from the Medicare FFS program. MA plan bids are an estimate of projected costs that plans expect to incur, in part based on policies under the Medicare FFS program that are generally established each year before MA benchmarks are finalized and bids are submitted. Applying those general principles here, we generally disagree with commenters’ alternatives. We disagree with the commenter’s suggestion that CMS should either directly pay MA organizations to distribute to affected 340B hospitals or direct in this Rate Announcement that MA organizations must account for what providers allege were prior inadequate MA payments from MA organizations. We understand from commenters that FFS rates, including the 340B adjustment, could potentially have downstream effects on how much MA organizations pay providers under their MA contracts. But the commenter cites no statutory authority requiring or even authorizing CMS to make direct payments to providers to account for allegedly inadequate payments by MA organizations. MA capitation rates released through the Advance Notice and Rate Announcement process do not set the amounts that MA organizations pay their contracted providers. In fact, section 1854(a)(6)(B)(iii) of the Social Security Act prohibits CMS from interfering in how much MA organizations pay contracted providers or direct how MA plans pay providers for particular items or services, like 340B-acquired drugs. We therefore do not agree that this Rate Announcement is the proper venue to re-negotiate payment amounts for particular items or services in provider contracts with MA organizations.