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The Save MEDICARE Act of 2026 implements significant reforms to Medicare Advantage plan payments and oversight beginning in 2028. The bill replaces the current county-based payment system with a standardized base payment amount adjusted for "favorable selection"—accounting for the fact that healthier beneficiaries tend to choose Medicare Advantage over traditional Medicare—with adjustments recalculated annually starting in 2029 based on Medicare Payment Advisory Commission methodology. It also accelerates Medicare Advantage audits by imposing strict one-year timelines for contract reviews and 60-day deadlines for medical record reviews, while authorizing the government to extrapolate audit findings across the entire Medicare Advantage population and hire recovery contractors funded through a 0.02 percent reduction in plan payments. Additionally, the legislation requires Medicare Advantage and prescription drug plans to reimburse the Department of Veterans Affairs for health care services provided to enrolled veterans, strengthens the VA's ability to recover costs from third-party insurers with 45-day payment deadlines and penalties up to $50,000 per claim, and prohibits Medicare Advantage plans from using financial incentive contracts that tie provider compensation to coding practices. These changes aim to reduce fraud, overpayments, and inappropriate coding in Medicare Advantage while improving coordination with veteran health care coverage.

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