Medicare Advantage Integrity Act of 2025

Key Points

• Sets a minimum adjustment level for Medicare Advantage payment benchmarks starting in 2026, so some areas can’t fall below that floor.
• This mainly affects places where traditional Medicare use is low, which can lead to lower Medicare Advantage benchmarks under current calculations.
• Requires Medicare Advantage plans to use at least half of any extra payment from this change on basic covered services (the core medical benefits).
• Could raise payments to Medicare Advantage plans in certain regions, which may influence what plans offer and what providers get paid in those areas.