United StatesPuerto Rico Medicare calculations would match Virgin Islands adjustment
For covered years beginning on or after January 1, 2027, Medicare would match Puerto Rico’s geographic adjustment to one used in the U.S. Virgin Islands.
What it does
For covered years beginning on or after January 1, 2027, Puerto Rico’s Medicare Advantage cost calculation would use the geographic adjustment for a U.S. Virgin Islands area.
Argument forMatching the adjustments could give Puerto Rico and the Virgin Islands more consistent treatment in Medicare Advantage cost calculations.
Argument againstUsing another territory’s adjustment might not reflect Puerto Rico’s own health care conditions as closely as a Puerto Rico-based adjustment.
More detail
Medicare would use the geographic adjustment for a U.S. Virgin Islands payment area when calculating Puerto Rico’s adjustment. It covers adjusted average per-person cost calculations for Medicare Advantage payment areas in Puerto Rico. This applies only to years named in clause (ii) of the federal law; those years are not listed here. The matching adjustment would apply to covered years beginning on or after January 1, 2027.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Oct 5Introduced in HouseLatest
- Oct 5Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.Introduced
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