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CMS adjusts September plan payment user fees

The September MARx cycle adjusts annual COB and MA-PD education fees, while PDPs have no September NMEC assessment. Earlier MLR remittances belong to the August payment reconciliation.

What happened

CMS’s August 31 MARx memorandum describes the September payment scheduled for September 1 and the final annual user-fee adjustments. The September coordination-of-benefits collection rises from 7.2 to 7.4 cents per member to reach the 2026 total of $0.65 after January–August collections. The MA-PD National Medicare Education Campaign rate rises from 0.021% to 0.029% for the September cycle to reach $108.9 million annually. PDPs have no September NMEC assessment because their $11.4 million maximum was reached in August. These are adjustments for that payment cycle, not permanent monthly rates.

Required 2024 medical-loss-ratio remittances were included in the August 2026 payment and identified on the Plan Payment Report by the MLR adjustment code. That is a separate reconciliation item from September user fees. The memorandum also explains consolidated parent tickets: a plan that has already reported an issue need not submit duplicate action when its ticket is consolidated. Finance teams can use the stated plan-type exceptions and payment months to investigate differences, without assuming the announced schedule proves an individual payment was received.

Scope and timing

Authority status
Final
Applicability
Potentially applicable
Audience
Health systems, Provider networks
Jurisdiction
Federal
Affected functions
Finance, Managed Care, Compliance
Responsible owner
Finance

Why it matters

A fee catch-up, a plan-type exception and an earlier MLR adjustment explain different remittance items. Combining them can produce an incorrect reconciliation.

Sources

Complete edition and supplemental material

This finding in the complete approved report →

Regulatory horizons, CIA trends and implementation trackers remain in the full report.

Read the entire Medicare & Medicaid report →

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