CMS Announces CY 2026 Bid Submission Functionality in HPMS for Medicare Plans
Relevant to: PDP, Audit Protocol, Enrollment and Payment Systems, Formulary Enhancement Submission, 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.
Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.
Click here for detailed information on the bid submission process for CY 2026 in HPMS.
Introduction
The Centers for Medicare & Medicaid Services has announced the launch of the Contract Year 2026 bid submission functionality in HPMS. This update is essential for Medicare Advantage, Prescription Drug Plan, Section 1876 Cost, and PACE organizations. With a submission deadline of June 2, 2025, organizations must complete all necessary bid components promptly to ensure compliance with CMS requirements. Get ready to navigate the bid submission process, ensuring all essential data is entered and validated for successful submission.
Key Dates and Deadlines
- Bid submission deadline: 11:59 p.m. PDT on June 2, 2025
- Supplemental formulary uploads due by: 11:59 a.m. EDT on June 6, 2025
- Service Area Verification (SAV) release date: April 18, 2025
PACE Compliance
This memo is relevant to PACE programs in several ways due to its detailed guidance on the bid submission process for the Contract Year 2026. Although many of the specific submissions, such as the Bid Pricing Tool (BPT) and Plan Benefit Package (PBP), are aimed at Medicare Advantage and Prescription Drug Plans, PACE organizations might still benefit from understanding the submission process and requirements for compliance or future planning purposes.
PACE organizations are required to comply with specific service area verifications as mentioned in the memo, which highlights the need for reviewing and validating contract service areas. An accurate verification process is essential to overcoming any discrepancies that may delay the CMS bid desk review process.
Plans must ensure compliance with:
- Service Area Verification (SAV): Complete by reviewing the entire contract service area and ensuring no discrepancies exist. Non-concurrence with any service portion must be resolved with CMS to avoid delays.
- Plan Crosswalk: Required by the bid submission deadline to identify relationships between current year plans and the upcoming year for beneficiary transition awareness.
- Formulary Submissions: While PACE does not generally require formularies like Part D plans, understanding the crosswalk and formulary submission process could aid in aligning operations with CMS expectations for integrated care models.
The memo also suggests ensuring plan users have the right HPMS access for relevant functionalities, which might indirectly impact PACE organizations if they expand services resembling those offered by entities using HPMS for submissions.
Service area verification and crosswalk submission are critical components to ensure compliance, and PACE programs should carefully coordinate with CMS to validate their operational areas for accuracy and compliance.
Required Actions
1. Access the HPMS system and navigate to Plan Bids > Bid Submission > CY 2026 > Upload to utilize the newly released CY 2026 bid submission functionality.
2. Complete all required bid submission components in HPMS, including the Plan Benefit Package (PBP), Bid Pricing Tool (BPT), Formulary Submission, Service Area Verification, Plan Crosswalk, and any necessary substantiation and cost-sharing justification by June 2, 2025.
3. After the initial bid submissions, ensure that all additional required documents, such as the Initial Actuarial Certification and Supplemental Formulary Uploads, are submitted by their respective due dates, including June 6, 2025, for formulary uploads.
FAQs
- “What is the deadline for the CY 2026 bid submission in HPMS?”
- “What components are required for a complete bid submission for CY 2026?”
- “How can organizations verify their service area for the CY 2026 contract?”
- “What is the process for completing a plan crosswalk in HPMS?”
- “How should organizations handle discrepancies in their contract service area?”
Click here for detailed information on the bid submission process for CY 2026 in HPMS.
