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Health Plan Accountability Update: October 2025
The AHA May 29 submitted a letter to the Centers for Medicare & Medicaid Services responding to a request for information regarding Medicare Advantage data, urging CMS to increase oversight of the program.
AHA encourages MedPAC to refine analysis of MA enrollment impacts on patients, providers
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on hospitals, which found that increased enrollment is not statistically associated, on average, with all-payer hospital margins.
AHA Comments on MedPAC Analysis of MA Enrollment Changes
AHA comments on the Medicare Payment Advisory Commission’s preliminary analysis of the association between Medicare Advantage (MA) enrollment changes and hospital finances shared during the September public meeting.
CMS finalizes Medicare Part C Utilization Management Annual Data Submission requirements
The Centers for Medicare & Medicaid Services Sept. 30 issued a memo, through the Health Plan Management system, finalizing the Medicare Advantage Utilization Management Annual Data Submission requirements for MA organizations.
AHA provides recommendations to HHS, CMS for insurers to adhere to prior authorization pledge
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.
CMS says premiums, enrollment for MA and Part D to slightly decline for 2026
The Centers for Medicare & Medicaid Services announced Sept. 26 that average premiums for Medicare Advantage and Part D would decline slightly in 2026.
AHA-supported legislation would apply prompt payment standard to MA plans
The AHA expressed support Sept. 22 to House and Senate sponsors of the Medicare Advantage Prompt Pay Act (H.R. 5454/S. 2879), legislation that would apply a federal prompt payment standard to MA plans to help ensure that health care providers receive timely payments from MA plans for necessary patient services.
AHA Supports Senate Medicare Advantage Prompt Pay Act (S. 2879)
The AHA expresses support for the Senate Medicare Advantage Prompt Pay Act (S. 2879).
AHA Supports House Medicare Advantage Prompt Pay Act (H.R. 5454)
AHA expresses support for the House Medicare Advantage Prompt Pay Act (H.R. 5454).
CMS issues final rule on CY 2026 policy and technical changes to Medicare programs
The Centers for Medicare & Medicaid Services Sept. 18 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly for contract year 2026.