Medicare Advantage in the headlines: 7 recent updates

CMS proposed a payment bump for Medicare Advantage plans in 2026, and insurers are continuing to file challenges over star ratings. 

Here are seven Medicare Advantage updates Becker's has reported since Dec. 30. 

  1. Partnerships will be key to easing Medicare Advantage tensions between hospitals and insurers, Rick Pollack, CEO of the American Hospital Association, said on the Becker's Healthcare podcast on Jan. 23.

    "I think what we really need to focus on are partnerships that allow hospitals, health systems and other stakeholders — some of them may be insurers — to work together to align these incentives," Mr. Pollack said.

  2. CMS issued nearly $2.5 million in fines on Jan. 17 across seven health plans for Medicare contract violations related to Part C and Part D issues.

  3. Though Medicare Advantage beneficiaries are more likely to have coverage of vision, dental and hearing services, they are not more likely to use these services than their peers in traditional Medicare, a study published Jan. 14 in JAMA Network Open found.

  4. Two relatively newer insurers in the Medicare Advantage market saw spikes in enrollment for 2025. Clover Health, launched in 2014, grew its Medicare Advantage membership 27% year-over-year. Alignment Healthcare, founded in 2013, saw MA membership increase by 35%.

  5. CMS is facing at least a half-dozen lawsuits over its 2025 Medicare Advantage star ratings. Alignment Healthcare was the latest MA insurer to sue CMS, alleging it acted wrongfully when assigning 2025 star ratings. The company filed a complaint Jan. 10 in federal court in Washington, D.C., alleging CMS and its contractors made "significant mistakes" in their handling of Alignment's MA star ratings.

  6. CMS proposed a more generous increase in payments to Medicare Advantage plans in 2026 than in previous years. The agency estimates payment rates to MA plans will increase by 4.33%, or $21 billion in 2026, according to an advance notice published Jan. 10.

  7. HHS' Office of Inspector General estimated three Medicare Advantage insurers received around $11.4 million in overpayments, according to audits published Dec. 23-26. 
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