The payment proposal published on January 10 by the Centers for Medicare & Medicaid Services (CMS) for the Medicare Advantage (MA) fails to address the historic disparity in payments for beneficiaries in Puerto Rico. These rules will take effect in January 2026.
The healthcare industry is hopeful that the new Trump administration, with its more favorable stance toward the Medicare Advantage program and its vision of a more efficient and cost-effective government, will propose changes to the formula used by CMS to ensure fairness for Puerto Rico and other jurisdictions in similar situations.
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