💊Key Medicare and Medicaid Regulatory Changes for 2026
Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly
Summary
This final rule revises the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to prescription drug coverage, the Medicare Prescription Payment Plan, dual eligible special needs plans (D-SNPs), Part C and D Star Ratings, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This final rule also codifies existing sub-regulatory guidance in the Part C and Part D programs.
Agencies
- Health and Human Services Department
- Centers for Medicare & Medicaid Services
Business Impact
$$$ - High
The document contains substantial regulatory changes regarding Medicare and Medicaid that directly affect business owners in healthcare and pharmaceutical sectors, including requirements for cost-sharing caps on insulin and adult vaccines. These implications extend to compliance and potential financial adjustments within these industries.