This bill significantly reforms the Medicare Advantage (MA) program, primarily effective January 1, 2028, by mandating that MA plans pay for benefits on a capitated basis , with limited exceptions for existing enrollees and specialized plans. It introduces substantial changes to MA plan payments, including a reduction in the blended benchmark amount to 75% and modifications to risk adjustment. Specifically, risk adjustment for health status will rely solely on diagnoses from face-to-face or telehealth visits, excluding chart reviews, and will use a two-year look-back period. The legislation also eliminates quality-based increases to the applicable percentage for MA plans and allows the Secretary to establish budget-neutral stop-loss payments for plans experiencing unexpectedly high expenditures. Furthermore, it institutes automatic enrollment for eligible beneficiaries into the lowest-premium MA plan available, though individuals retain the option to decline this enrollment. A significant change is the introduction of a mandatory three-year continuous enrollment period , preventing beneficiaries from switching plans or returning to traditional Medicare during this time, except in cases of hardship. Finally, the bill requires MA plans to include hospice care and creates a new Stark Law exception for designated health services like durable medical equipment or Part D drugs furnished under an MA plan.