The purpose of this web page is to increase transparency related to the Medicare Part C Utilization Management (UM) Annual Data Submission (CMS-10913, OMB 0938-1488), which CMS finalized and announced in a Health Plan Management System (HPMS) memo issued on September 30, 2025.
Starting in 2026, all Medicare Advantage (MA) organizations (MAOs) must submit information on internal coverage criteria used by their organization or delegated entities to process prior authorizations for Medicare Part C services.
The initial UM annual data submission applies to the 2026 coverage year and is due April 30, 2026. For subsequent coverage years, an updated data submission is due annually by February 28th.
See the Download section below for the approved protocol and HPMS memos that announce the final protocol and provide technical guidance on how to submit the UM annual data to CMS.
For any questions related to the UM annual submission, please email CMS_PartC_UM_Audits@cms.hhs.gov.