Page 78

78

Response: CMS thanks the commenters for their support. Comment: Several commenters requested that CMS announce before the bid submission deadline, ideally with the CY 2026 Rate Announcement, the premium stabilization and risk corridor parameters for CY 2026 under the voluntary demonstration program for standalone PDPs announced by CMS in July 2024. Response: CMS thanks the commenters for their input. Without first receiving and analyzing bids submitted for CY 2026, CMS cannot assess the need for, or effectiveness of, the elements of the demonstration in achieving the goals of the demonstration and whether market conditions suggest that Part D sponsors have adequate data on the Part D market following implementation of the Part D benefit changes under the IRA to have stable actuarial information on which to base their PDP bids in the absence of additional premium stabilization. Without such information, CMS would not be able to determine either the need or the appropriate parameters for each element of the demonstration for CY 2026. It is important to note that since changes to the Part D benefit will be relatively modest in 2026, and PDPs will have some experience with the 2025 changes that will help inform their 2026 bids, CMS anticipates that the factors contributing to the design and magnitude of the CY 2025 demonstration parameters will be significantly mitigated for CY 2026. CMS will take these factors into account in determining the appropriate level of premium stabilization and/or narrowed risk corridors for participating PDPs in CY 2026 if necessary to continue to stabilize premiums. We also remind Part D plan sponsors that, under the statute per section 1860D–11 of the Act, the Secretary has the authority to negotiate the terms and conditions of proposed bids and does not have to accept any or every Part D bid submitted. Therefore, consistent with the terms of the demonstration as announced in July 2024, CMS will announce any additional premium stabilization and the risk corridors for participating PDPs for CY 2026 no later than the annual release of the NAMBA, Part D BBP, and related Part D bid information in the summer of 2025. Section E. Retiree Drug Subsidy Amount No comments received. Section F. RxHCC Risk Adjustment Model Comment: Several commenters expressed support for updating the RxHCC models to account for changes in the Part D standard benefit design for CY 2026. Some commenters specifically expressed support for reflecting maximum fair prices (MFPs) under the Medicare Drug Price Negotiation Program in the model calibration. A commenter said that MFPs are a known amount for the 2026 plan year, and that a model that does not account for the MFPs would create an adverse incentive for plans to prefer members using selected drugs over those with conditions