CMS Proposes Medicare Advantage and Part D Updates to Simplify Star Ratings

CMS has proposed updates to the 2027 Medicare Advantage (MA) and Medicare Part D programs focused on improving the Star Ratings system to enhance enrollee care. Key changes include simplifying the Star Ratings by removing 12 administrative and less impactful quality measures, while retaining the methodology that rewards consistently high-performing plans. A new Depression Screening and Follow-Up measure is proposed for 2029 to address beneficiaries' mental health needs. The proposed rule also suggests introducing a new special enrollment period for cases of provider terminations and codifying existing policies regarding special enrollment periods. CMS has requested public input through a 60-day comment period and a Request for Information aimed at modernizing Medicare Advantage to better serve beneficiaries and optimize program effectiveness. These adjustments reflect CMS's ongoing effort to shift Medicare programs toward value-based care by focusing on clinical outcomes, patient experience, and operational simplicity. Stakeholders in the Medicare ecosystem should monitor these developments as they may impact compliance, plan performance metrics, and member engagement strategies.