Week in Washington

CMS recalculating MA Stars Rating

CMS announced it would be recalculating MA STARS for plans that would benefit from a different calculation. The change stems from the recent lawsuit loss to Clover over its STAR Rating methodology. Plans will be held harmless but for plans that do benefit have until June 22^nd to notify CMS that they plan to resubmit and until June 29^th to file their updated bids. CMS made no comment on how this would affect future STAR ratings although it’s likely these issues will be addressed in upcoming regulations. If you have questions about how these STAR rating changes affect you, feel free to reach out to Wakely.

ACA Participation Down

KFF released new analysis on issuer participation in the ACA Marketplace and found overall participation declined in 2026 to about 9 issuers per state. This is down from the record high of 9.6 in 2025. The lowest amount of participation occurred in 2017 when there were only 5.4 issuers per state.

MedPAC Report

MedPAC released its June report with a specific focus on improving payment incentives in Medicare. Including in the report were recommendations on improving Alternative Payment Models, with a specific focus on changing risk adjustment and focusing more efforts on reducing specialist spending.

CMS Regulations

CMS released a number of proposed regulations this week on 1) Accrediting Organization oversight,  drug price negotiations, and Medicaid 1115 Waiver standards.