CMS Releases CY 2026 Medicare Advantage Plan and Part D Final Rule

The Situation Report | July 21, 2025

Plan Payment Rates to Increase by $25 Billion Nationally  

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued the Contract Year (CY) 2026 Medicare Advantage (Part A) and Part D Final Rule here. 

According to CMS, Medicare Advantage (MA) plans can expect a payment increase of 5.03% in 2026, more than double what the previous administration proposed. In the final days of the previous Administration, CMS proposed a 2.23% funding increase for MA plans. The payment increase is significantly more than MA plans received in previous years. 

The rule also implements changes related to prescription drug coverage, various Part D policies, Dual Eligible Special Needs Plans (D-SNPs), the Star Ratings system, and other programmatic areas. 

CMS did not finalized these other provisions from the proposed rule: Enhancing Health Equity Analyses: Annual Health Equity Analysis of Utilization Management Policies, Procedures and Ensuring Equitable Access to Medicare Advantage Services, Guardrails for Artificial Intelligence, and Part D Coverage of Anti-Obesity Medications (AOMs) and Application to the Medicaid Program). 

While the rule does not directly address home health services, certain provisions like the increased payments to MA plans may have positive implications for contracted agencies or providers delivering care in the home setting. 

HCANYS will keep you informed of any further changes.