Timeline: A History of the Biden Administration’s Medicare Advantage Payment Policies

Jan 16
Jan 16, 2025

Less than two weeks before the inauguration of President-elect Donald Trump, CMS on Jan. 10 released its last set of payment updates for Medicare Advantage and Part D under President Joe Biden. In the 2026 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies, the Biden administration proposed to complete its three-year transition to the 2024 CMS-Hierarchical Condition Categories (CMS-HCC) risk adjustment model (aka, version 28 or v28). At the same time, it included an update to the Medicare Part D RxHCC risk adjustment model to reflect the impact of benefit changes under the Inflation Reduction Act, which Biden signed into law in 2022.
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.