US Senator Roger Wicker requested on 16 October that the Department of Health and Human Services and Centers for Medicare & Medicaid Services adjust Medicare payment calculations for territories starting in 2028.^[1] Wicker wrote urging the agencies use administrative authority to address deficiencies in Medicare Advantage payment calculations for regions with low participation in Original Medicare.^[2] The letter joins a separate submission from 14 Republican congressmen led by Representative Greg Murphy supporting adequate financing for the territory.^[3] Approximately 680,000 residents in Puerto Rico are enrolled in Medicare Advantage.^[4] Current base payment rates in Puerto Rico are approximately 40% below the US national average and 20% below rates in the US Virgin Islands.^[5] The proposal under discussion suggests using claims data from a comparable region such as the US Virgin Islands to set a payment reference. This would bring Puerto Rico Medicare Advantage payments to 70% of the national average starting in 2028.^[6] José 'Che' Aparicio, president of the Puerto Rico Chamber of Commerce, stated the organization supported federal efforts to correct the payment disparities.^[7] Evaluation of payment rates uses performance data, peer recommendations, accreditations and satisfaction data from CMS.^[8]