14. Department of Health and Human Services · Notable · Needs Congress
Replace Medicare Advantage's payment formula with competitive bidding
Printed page 465 14. Department of Health and Human Services
“Replace the complex formula-based payment model with a competitive bidding model.”
What has happened
- Not started
Medicare Advantage is still paid off statutory benchmarks derived from fee-for-service county rates, not competitive bids in the sense the Mandate means. No bill of the 119th Congress proposes MA competitive bidding — the only "competitive bidding" bill in the Corpus, S. 2951, is about durable medical equipment relief and is in committee — and the CY 2027 Advance Notice (2026-01-26) sets rates by the same benchmark/rebate methodology. Negative search recorded in `docs/research/ch-14.md` under the round-2 (ticket 16) cluster searches.
No action found yet. This entry is the starting point, not a finding.
Research log
What was searched, and what didn’t count as evidence
Research notes
- Searched: the titles of the bills we keep and search, for “competitive bidding” → 1 (S. 2951, Competitive Bidding Relief Act, referred 2025-09-30, durable medical equipment); for “Medicare Advantage” → 11, none on payment methodology. Federal Register “competitive bidding” in-window returns the DMEPOS competitive bidding program only.
- The CY 2027 Advance Notice (cms.gov, 2026-01-26) was read: growth percentage, benchmarks, normalization and coding-intensity adjustment all follow the statutory formula.
- Action
- other
- Object
- Medicare Advantage payment model
- ID
- 1263