Medicare

Medicare Advantage's Retreat: From the 2026 Rate Hike to the 2027 Plan Exits and Open Enrollment

CMS raised Medicare Advantage payments 5.06% for 2026, then launched an every-contract annual RADV audit strategy aimed at unsupported risk-adjustment diagnoses. The audit effort has been constrained by a court ruling vacating the extrapolation rule, and CMS has not yet decided whether to collect extrapolated payment-year 2024 overpayments.