ASAM Submits Comments on 2026 Medicare Advantage & Part D Proposed Rule

On January 27, ASAM provided comments to the Centers for Medicare & Medicaid Services (CMS) regarding its calendar year 2026 Medicare Advantage (MA) and Part D proposed rule. ASAM recommends that CMS:

• Finalize proposals to limit cost-sharing in MA and Medicare cost plans (cost plans) to no more than the amounts allowed in traditional Medicare in contract year 2026;
• Collect data on the impact of these cost-sharing limits on plan contracting arrangements with clinicians;
• Determine whether the proposed cost-sharing limits may be applied to medications to treat addiction;
• Finalize proposal to ensure MA provider directories are included in the Medicare plan finder by 2026 and be updated on a regular basis; and
• Finalize proposed updates to regulations governing internal coverage criteria.

Overall, ASAM welcomes several proposals outlined in the rule that aim to expand beneficiary access to mental health and SUD services in MA and cost plans through efforts to limit beneficiary cost sharing, streamline provider directories, and more.

Read the full comment letter here.