2026 Medicare Standardized Materials Released: Key Updates and Changes
Relevant to: PDP, PDF, TrOOP, 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 has issued a memo detailing the release of the Contract Year 2026 Standardized Materials for Medicare Advantage and Prescription Drug Plans. This includes key documents such as the Annual Notice of Change (ANOC), Evidence of Coverage (EOC), and updates to ensure better communication of healthcare service prices for beneficiaries. These changes are part of efforts to promote price transparency and reduce administrative burdens on organizations through streamlined documents.
Key Dates and Deadlines
- Date of memo issuance: June 16, 2025
- Contract Year for which the updates apply: 2026
- List of updates and changes related to CY 2026 materials, released on the date of memo issuance
- CMS requirements for organizations and sponsors regarding CY 2026 materials must be in compliance by the start of the contract year, January 1, 2026
PACE Compliance
This memo outlines the issuance of Contract Year 2026 Standardized Materials, including various notices, directories, and explanation documents. PACE organizations must ensure their materials comply with the CMS requirements stated in the memo. The updates aim to improve consumer comprehension and administrative efficiency. Specifically:
1. Use of updated models: PACE organizations should integrate the revised ANOC and EOC models into their materials, as they include changes in formatting, language, and structure.
2. Mailing requirements: Compliance with 42 C.F.R. §§ 422.2267 and 423.2267 relating to mailing standards is necessary. Organizations should ensure that all materials are distributed according to established schedules and regulations.
3. Regulatory requirements: Modifications to sections such as the LIS Rider mailing and various chapter updates must be understood and applied. PACE organizations should consult Appendix A of the models for detailed guidance and regulatory requirements.
4. Plan Instructions: All specific instructions regarding transitioning plans, updating definitions, and providing resource links should be carefully followed to maintain compliance, especially in the `About [plan name]` sections and during transitions from D-SNP look-alikes.
Ensuring compliance with these adjustments not only satisfies CMS regulations but also supports clear communication and effective service delivery to beneficiaries.
Required Actions
This memo details updates for Contract Year 2026 Standardized Materials. The actions to take are:
- Review the changes and modifications to CY 2026 Standardized Materials, including ANOC, EOC, and related documents.
- Ensure compliance with CMS requirements for CY 2026 materials by incorporating necessary regulatory and operational guidance as indicated in the memo.
- Consult with your CMS Account Manager or Marketing Reviewer to address any questions or clarifications needed regarding the updates and requirements.
FAQs
- “What are the CY 2026 standardized materials?”
- “How has the ANOC and EOC been updated for 2026?”
- “What new guidance is included in the CY 2026 documents?”
- “How do the CY 2026 changes align with patient empowerment through price transparency?”
