Last month, CMS released the Contract Year (CY) 2027 Medicare Advantage and Part D Proposed Rule, a comprehensive set of policy and technical changes that, if finalized, would influence how MA and Part D plans are measured, compared, and administered.
Key Proposed Changes
- Star Ratings Overhaul: CMS proposes major updates to the Star Ratings system—removing 12 measures focused on administrative processes, discontinuing the Health Equity Index reward, and adding a new measure for depression screening and follow-up—so plans can focus more on clinical care, outcomes, and beneficiary experience.
- Enrollment Improvements: The rule includes a new Special Enrollment Period (SEP) for beneficiaries who lose access to providers due to network changes, and it codifies long-standing SEP policies to provide clarity and stability.
- Part D Redesign Codification: Many Part D provisions originally introduced through guidance—as part of the Inflation Reduction Act—would be formally codified. These include eliminating the coverage gap phase, setting a reduced out-of-pocket threshold, and implementing the Manufacturer Discount Program that replaced the Coverage Gap Discount Program in 2025.
- Requests for Feedback: CMS is also seeking input through Requests for Information (RFIs) on topics like risk adjustment modernization and better coordination of care for dual eligible populations.
What This Means for Brokers
For brokers, these proposals signal continued evolution in both quality measurement and beneficiary access provisions. Changes to Star Ratings could shift how plans perform and are perceived in public reporting, while new enrollment policies may impact conversations with clients navigating network changes mid-year. Codification of Part D redesign elements reinforces recent shifts around out-of-pocket costs and benefit structure.
Next Steps & Comment Period
CMS is accepting public comments on the proposed rule through January 26, 2026, giving stakeholders—including agents and brokers—an opportunity to weigh in on issues that affect plan design, marketing, and service delivery. Staying engaged during this period can help inform final policies for 2027.
Read the Full Post From CMS
https://www.cms.gov/newsroom/fact-sheets/contract-year-2027-medicare-advantage-part-d-proposed-rule