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

Representing Medicaid & Medicare Advantage Products Association of Puerto Rico (MMAPA), I participated in the first meeting of the Multisector Health Committee convened by Governor Jenniffer González Colón. We welcome this initiative with enthusiasm and a strong sense of commitment, confident that it can make a meaningful difference for the more than 1.3 million people—including thousands of children—who rely on the Medicaid program to access healthcare and essential services

The Medicare Advantage (MA) 2026 Rate Announcement reduced funding for Puerto Rico, with projected losses exceeding $400 million. MA plans in Puerto Rico should serve as a national model due to their cost- effectiveness and high quality of care; however, current MA rates are unsustainable and are contributing to instability in Puerto Rico’s health care system. Stakeholders in Puerto Rico seek to continue working collaboratively with CMS and Congress to correct data disparitie

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 m

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