05/15/2025

LeadingAge Analyzes Final CY2026 Medicare Advantage Rules

The Centers for Medicare and Medicaid Services (CMS) finalized two Medicare Advantage rules governing 2026. The 2026 MA Rate Notice will increase the amounts paid to MA plans by an average of 5.06% and clarifies that all MA plan coverage determinations must follow the rules –including concurrent reviews -- related to how quickly a determination is made, reinforcing beneficiary appeal rights, provider notifications and distinguishing between payment and service determinations. The key elements of the final rules are analyzed in this LeadingAge article.