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This proposed rule would make changes to strengthen and improve the Medicare Advantage (Part C) and prescription drug benefit (Part D) programs, and Programs of All-Inclusive Care for the Elderly (PACE), and implement any legislative changes that are required by January 1, 2025.

Statement of Need:

This proposed rule is necessary to amend the regulations for the Medicare Advantage (Part C) program, Medicare Prescription Drug Benefit (Part D) program, Medicare cost plan program, and Program of All-Inclusive Care for the Elderly (PACE) to implement certain statutory requirements, to codify existing subregulatory guidance, and based on our continued experience in the administration of the programs.

Summary of the Legal Basis:

This rule addresses multiple sections of the Social Security Act and proposes to codify existing Part C and Part D subregulatory guidance. It would also implement certain sections of the Bipartisan Budget Act of 2018 and the Consolidated Appropriations Act (CAA), 2023.

Alternatives:

This rule would implement provisions that require public notice and comment and are necessary for the upcoming contract year. We will continue to explore additional alternatives as we develop the rule.

Anticipated Costs and Benefits:

Preliminary estimates of the anticipated costs and benefits of this proposed rule indicate minor costs (under $50 million) associated with increased paperwork as well as some savings to the Medicare Trust Fund. Numerical estimates are pending and as we move toward publication, estimates of costs and benefits will be included in the proposed rule.

Risks:

Risks associated with the impact of this rule are under development and will be included in the published rule.