MMAPA Highlights Senator Roger Wicker’s Letter Urging CMS to Address Medicare Advantage Payment Gap for 2028 San Juan, Puerto Rico – Puerto Rico’s call to address Medicare Advantage (MA) funding gap continues to gain support in the U.S. Congress. The Puerto Rico Medicaid and Medicare Advantage Products Association (MMAPA) welcomed a letter from U.S. Senator Roger F. Wicker (R-Mississippi) to the Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.

Autores: Raul Ruiz (D-CA), Gus Bilirakis (R-FL), el comisionado residente Pablo José Hernández (D-PR) y Darren Soto (D-FL) “This legislation represents an important step toward addressing a longstanding structural challenge in Medicare Advantage payments in Puerto Rico. With approximately 96% of Medicare beneficiaries on the Island choosing Medicare Advantage, the methodology used to establish Puerto Rico’s benchmarks must reflect the reality of the market it serves. We thank

The presentation of the Government of Puerto Rico’s report supporting its request for continued federal Medicaid funding brought together Governor Jenniffer González-Colón, Puerto Rico’s health leadership, PRFAA, Resident Commissioner Pablo José Hernández, and representatives from healthcare and business organizations. This multisector effort underscores the importance of working together and acting early to present Congress with data and solutions that reflect the needs of P

Washington, D.C. – A delegation from the Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA), joined by other health care leaders, concluded a visit to Washington, D.C., this week to advance concrete solutions for the more than 1.7 million people who rely on both programs for access to health care, and to ensure that data and policy options that address the unique characteristics of Puerto Rico’s health care system on the federal agenda. During the vis

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