Proposed rule
CMS-4214-P
What the 2028 Medicare Advantage and Part D proposal means for your organization. Comments are due December 15, 2026, at 5 p.m. Eastern.
Public sources only: the proposed rule, the NPPES registry, and a website you choose to share. Patient records are not included.
What the proposal says
- Document
- 2026-21420
- Length
- 265 pages
- Filed
- October 16, 2026
- Comments due
- December 15, 2026
Federal Register publication is scheduled for October 20, 2026. The citation will be added when it publishes. These figures are proposed in § 422.123(d)(4). They are not a final rule.
Table 1 weights
Proposed § 422.123(d)(4). Network status is the field that moves the grade.
- Network participation status40%
- Contact information, including telephone numbers20%
- Primary office or facility address20%
- Specialty10%
- Accommodations for people with disabilities3.5%
- Telehealth capabilities3.5%
- Whether the provider is accepting new patients3%
Letter grades
Proposed § 422.123(d)(4)(vi). A rounded composite score converts as follows.
- A90 to 100 percent
- B80 to 89 percent
- C70 to 79 percent
- D60 to 69 percent
- E50 to 59 percent
- F49 percent and below
The proposed 90-day verification cycle may use internal plan information, phone, email, provider attestation, or NPPES. CMS has not proposed to limit which of those a plan uses for that cycle.
A point commenters may raise: because network status is 40% of the grade, a plan with 25% of listings wrongly marked in network and everything else right still scores 90, an A.
Sources: the CMS fact sheet and press release of October 16, 2026, and public-inspection document 2026-21420. Comments go to regulations.gov, docket CMS-2026-2533. Rivvi is not affiliated with CMS.