The conversation must go beyond how much funding is provided and for how long. Puerto Rico needs adequate, stable, and predictable Medicare Advantage funding that reflects the needs of its patients and health care system. With CMS currently developing its 2028 payment policies, the window to address this funding gap is now. This is not a five-year fight. It's about ensuring access to care and preserving a strong network of doctors and providers for the people of Puerto Rico.

Led by Rep. Greg Murphy (R-NC), the proposal calls on HHS and CMS to establish a minimum Medicare Advantage payment floor for Puerto Rico beginning in 2028, comparable to the U.S. Virgin Islands. The request comes as CMS develops the proposed 2028 MA rule and could impact 96% of Medicare beneficiaries on the island—the highest MA participation rate in the nation. Why it matters: Puerto Rico offers a unique Medicare Advantage case study for federal policymakers: 96% of Medicar

MMAPA is asking CMS not to apply the new Medicaid payment restrictions to Puerto Rico in the same way as the states. Puerto Rico already has limited Medicaid funding and ongoing provider shortages. MMAPA is concerned that additional restrictions on State Directed Payments could make it harder to retain providers, maintain adequate healthcare networks, and ensure Medicaid patients have access to care.

San Juan, Puerto Rico – Representatives of Puerto Rico's healthcare sector concluded a series of meetings this week with Members of Congress and federal agencies, where policymakers expressed growing interest in identifying solutions to strengthen Medicaid and Medicare Advantage, two programs that are the backbone of Puerto Rico's healthcare system.

On June 3, healthcare leaders representing diverse sectors of Puerto Rico’s healthcare community came together to discuss the current landscape of Medicaid and Medicare Advantage and explore opportunities to further strengthen both programs. At a time when critical decisions are being made regarding the future funding of these programs, collaboration, information-sharing, and stakeholder engagement are more important than ever. Puerto Rico has a proven track record of deliver

The release of the 2027 Medicare Advantage rates marked an important step forward, but the decisions that will shape Puerto Rico's healthcare future are already being developed for 2028. Recognizing this critical moment, MMAPA recently submitted a letter to CMS leadership reinforcing the need for permanent solutions to the structural funding disparities that continue to impact Puerto Rico's Medicare Advantage program. Building on the ongoing collaboration among CMS, the Admin

The release of the 2027 Medicare Advantage rates marked an important step forward, but the decisions that will shape Puerto Rico's healthcare future are already being developed for 2028. Recognizing this critical moment, MMAPA recently submitted a letter to CMS leadership reinforcing the need for permanent solutions to the structural funding disparities that continue to impact Puerto Rico's Medicare Advantage program. Building on the ongoing collaboration among CMS, the A

The final Medicare Advantage rates for 2027 represent an important step forward by preventing additional cuts and protecting a program that serves more than 679,000 beneficiaries in Puerto Rico. This outcome reflects the impact of sustained engagement among federal leaders, the Puerto Rico government, and key stakeholders who have elevated the urgency of addressing the island’s Medicare Advantage funding challenges. However, continued collaboration with federal leadership wil

This week, a MMAPA delegation is in Washington, D.C. participating in the MHPA Policy & Leadership Forum, representing the interests of patients and Puerto Rico’s healthcare system. As part of the agenda, we met with congressional leaders to continue advancing discussions on the importance of Congress addressing Medicaid funding for the Island—an essential issue to ensure an adequate and accessible healthcare system. Among these meetings, we engaged with Jonathan Kupperman of

That is why each year’s Medicare Advantage payment policies are so important for the stability of healthcare on the Island. The Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the 2027 Medicare Advantage Advance Notice. In our letter, we highlight the importance of ensuring that payment methodologies accurately reflect markets where Medicare Advantage is the prim

MMAPA urged the Centers for Medicare & Medicaid Services (CMS) to keep Puerto Rico excluded from the policy that would limit dual-eligible beneficiaries—known as D-SNPs—to only one plan option. These Medicare Advantage plans are a vital lifeline for thousands of older adults who qualify for both Medicare and Medicaid, as they allow them to receive coordinated care, lower out-of-pocket costs, and access benefits that truly make a difference in their daily lives. In an island w

MMAPA thanks all organizations that participated in the most recent Healthcare and Business Community Meeting convened by the Medicaid and Medicare Advantage Products Association of Puerto Rico. Representatives from healthcare providers, health plans, community-based service providers, and other stakeholders demonstrated a shared commitment and a clear understanding of the collective responsibility we hold toward the millions of people in Puerto Rico who depend on Medicaid an

MMAPA supports the Apples-to-Apples Comparison Act (H.R. 4093) for its focus on improving transparency and access to consistent data across the Medicare program. More complete and comparable utilization and spending data for Traditional Medicare and Medicare Advantage will support CMS’s ongoing efforts to refine payment and analytic methodologies, including those affecting Medicare Advantage funding levels in Puerto Rico, which remain 40% below the national average.

MMAPA, along with 60 organizations, supports the Better Medicare Alliance sign-on letter urging Congress to reject Medicare Advantage cuts included in the No UPCODE Act. The proposed changes would undermine care coordination, restrict in-home care, and reduce access to preventive and supplemental benefits that are critical for Medicare Advantage beneficiaries. In Puerto Rico, where Medicare Advantage plays an essential role in stabilizing the healthcare delivery system and ma

33 organizations form the Puerto Rico Healthcare Coalition (PRHC) submitted today a Community Letter to CMS, requesting three concrete and urgent actions for the Medicare Advantage program in Puerto Rico: Establish a reasonable benchmark floor; Implement a minimum Average Geographic Adjustment of 0.70 t; and Work with Congress to extend essential federal programs (MSP, LTSS, LIS, SSI, SNAP) to Puerto Rico With 96% of Medicare-eligible older adults in Puerto Rico enrolled in M

We commend Resident Commissioner, Pablo José Hernández, for introducing the Medicare Advantage Integrity Act of 2025, a vital step toward addressing the payment disparities that have long disadvantaged Puerto Rico within the Medicare Advantage program. By establishing a reasonable floor for benchmark rates in regions with high Medicare Advantage penetration, this bill ensures that seniors in Puerto Rico receive access to care and benefits comparable to those on the mainland.

MMAPA proudly participated in the Leadership Luncheon of the National Conference of Puerto Rican Women (NACOPRW) at the Centro para Puerto Rico in San Juan. Before an audience of leaders from NACOPRW chapters across the United States, Solange De Lahongrais, Esq., delivered a compelling message on the urgent need for Medicare equity for Puerto Rico. She underscored the funding disparities that place Puerto Rico’s Medicare Advantage base rates 39% below the national average, de

We are honored to have participated in the 2025 Better Medicare Alliance Leadership Forum, sharing Puerto Rico’s unique experience as a national case study for the future of Medicare Advantage. With 96% of eligible seniors enrolled — and one of the most integrated models for duals in the nation — Puerto Rico illustrates both the success and the challenges of the MA program. Our discussion focused on how the island’s model — born out of necessity and innovation — demonstrates

(San Juan, PR – September 26, 2025) – The Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA), founded 16 years ago to advocate for fair and equitable treatment in the island’s public health programs, today announced the election of Solange De Lahongrais, Esq. as its new president. With this appointment, De Lahongrais becomes the first woman to lead the association. De Lahongrais, who also serves as President of MMM Multihealth, assumes the leadershi

As President of the MMAPA Board, I reaffirm our commitment to a single goal: greater access and better health for Puerto Rico. This year, we are focusing on two fronts: supporting the Government of Puerto Rico in federal negotiations to ensure adequate Medicaid allocation and promoting fair Medicare Advantage compensation adjustments that protect our seniors. To amplify our impact, we are collaborating with the Better Medicare Alliance and will promote a Community Health Part