US EditionNABIP Urges CMS to Protect Beneficiary Access and Ensure Fair Agent Compensation in CY 2027 Medicare Rule
CMS proposes a less than 0.1% rate increase for Medicare Advantage in 2027 and limits chart reviews linked to $6.7 billion in improper payments, prompting industry opposition.
- On Jan. 26, Centers for Medicare & Medicaid Services officials proposed holding Medicare Advantage rates nearly flat for 2027, raising them by less than a tenth of a percent.
- High-Profile settlements and audit findings have driven CMS scrutiny of chart-review billing practices, with the Justice Department announcing a record $556 million settlement with Kaiser Permanente and audits estimating $6.7 billion in payments tied to chart-only diagnoses in 2017.
- Investigators found chart reviews almost always added diagnoses, with over 99 percent adding conditions, while many Medicare Advantage health plans hire medical coding and analytics consultants to bill these to the government.
- Some insurers saw stocks plunge and lobbyists warned 35 million seniors and people with disabilities could face cuts at October 2026 renewal; CMS opened a public comment period and plans an early April final decision.
- Spencer Perlman said `I do think the administration is serious about cracking down on overpayments,` and experts called the proposal encouraging, with Medicare Advantage now enrolling about 34 million members.
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LoudounTimes.com
NABIP Urges CMS to Protect Beneficiary Access and Ensure Fair Agent Compensation in CY 2027 Medicare Rule
WASHINGTON, Jan. 29, 2026 /PRNewswire/ -- The National Association of Benefits and Insurance Professionals (NABIP) recently submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) in response to the Contract Year (CY) 2027 Medicare Advantage and…
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Medicare Advantage health plans are blasting a government proposal this week that would keep their reimbursement rates flat next year while making other payment changes. But some health policy experts say the plan could help reduce billions of dollars in overcharges that have been common in the program for more than a decade. On Jan. 26, Centers for Medicare & Medicaid Services officials announced they planned to raise rates paid to health plans…
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