HHS CY2026 Bid Pricing Tool Revisions


On Dec. 20, HHS proposed collection on bid pricing tool revisions.


  • HHS proposed information collection relating revisions to the Bid pricing tool (BPT) software for Medicare advantage (MA) plans and to the Prescription drug plans (PDP).
  • Background
  • Medicare advantage organizations (MAO), PDPs are required to submit an actuarial pricing bid for each plan offered to Medicare beneficiaries for approval by the agency.
  • The MAOs and PDPs use the bid pricing tool software to develop actuarial pricing bid.
  • Competitive bidding process is annual process that applies to MA and Part D programs.
  • Proposed Revisions
  • Updates the contract year labels and references, also makes minor grammatical corrections within the bid instructions, changes apply for CY2026 through CY2029.
  • The revisions to the bid pricing tools were necessary for accuracy and applicability.
  • Consultation
  • Comments on collection due 30 days after publication in federal register, Jan. 19, 2025
  • Jan. 2025 HHS Issued Correction in Fed Reg
  • On Jan. 7, 2025, HHS issued a correction removing the language "insert date 30 days after date of publication in the Federal Register" and replace with Jan. 21, 2025.

Regulators HHS
Entity Types Ins
Reference 90 FR 1130, 1/7/2025; 89 FR 104182, 12/20/2024; CMS-R-65; CMS-10142;
Functions Claims/Accelerated Benefits; Compliance; Financial; Legal; Operations; Reporting; Risk; Underwriting
Countries United States of America
Category
State
Products Insurance; Insurance-Health; Medicare
Regions Am
Rule Type Final
Rule Date 12/20/2024
Effective Date 1/21/2025
Rule Id 238140
Linked to N/A
Reg. Last Update 1/7/2025
Report Section US Insurance

Last substantive update on 01/09/2025