Medicare CY 2026 Service Area Verification Now Available in HPMS
Relevant to: PACE, Part D
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
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Introduction
The Centers for Medicare & Medicaid Services (CMS) has introduced the Contract Year 2026 Service Area Verification (SAV) functionality within the Health Plan Management System (HPMS). This new feature requires all organizations and sponsors to ensure the accuracy and completeness of their contract service areas by the bid submission deadline, June 2, 2025. Organizations are expected to either concur or address discrepancies in their contract service areas to maintain compliance.
Key Dates and Deadlines
Memo released on April 22, 2025.
- Bid submission deadline: June 2, 2025
Organizations/sponsors are to verify their service area for the CY 2026 contract year.
PACE Compliance
This memo is relevant to PACE programs because it outlines the requirements for verifying service areas for the Contract Year 2026 in the Health Plan Management System (HPMS). Accurate service area verification is crucial for PACE organizations to ensure compliance with CMS requirements.
PACE organizations must:
- Verify their entire contract(s) service area and applicable attributes in HPMS for accuracy and completeness.
- Concur or non-concur with their CY 2026 contract service area as displayed in HPMS by the bid submission deadline of June 2, 2025.
- If non-concurring, provide an explanation, resolve any discrepancies, and submit through the SAV functionality in HPMS.
Failure to comply with these requirements may lead to issues with contract approvals or service delivery interruptions.
Required Actions
1. Verify your entire contract(s) service area and applicable attributes in HPMS to ensure accuracy and completeness by the bid submission deadline, June 2, 2025.
2. Review your service area(s) using the HPMS Plan Service Area Report and return to the SAV functionality to concur or non-concur with your service area as shown in the report.
3. Provide an explanation through HPMS for any non-concurrence and resolve discrepancies, verifying your contract service area(s) and submitting your non-concurrence via the SAV functionality.
FAQs
- “What is the Service Area Verification functionality for Contract Year 2026?”
- “How do organizations verify their contract service areas in HPMS?”
- “What steps should organizations take if they do not concur with their service area?”
- “Who should be contacted for technical assistance regarding HPMS?”
- “What is the deadline for organizations to submit their service area verification?”
