Medicare Advantage Consumer Protection and Transparency Act

Hozzl · 2024-12-19T09:06:51Z

Explore the details of House Bill 5854 Medicare Advantage Consumer Protection and Transparency Act currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on Health. Stay informed on legislative developments.

12/19/2024, 9:06 AM

Summary of Bill HR 5854

Bill 118 hr 5854, also known as the Medicare Advantage Consumer Protection and Transparency Act, aims to enhance consumer protections and increase transparency within the Medicare Advantage program. The bill was introduced in the House of Representatives on March 3, 2021.

The key provisions of the bill include requiring Medicare Advantage plans to provide clear and easily understandable information to beneficiaries about their coverage, costs, and network providers. This is intended to help beneficiaries make informed decisions about their healthcare options.

Additionally, the bill seeks to strengthen oversight of Medicare Advantage plans by requiring the Centers for Medicare and Medicaid Services (CMS) to conduct regular audits to ensure compliance with program requirements. This will help prevent fraud and abuse within the program. Furthermore, the bill includes provisions to improve access to care for beneficiaries by requiring Medicare Advantage plans to maintain an adequate network of healthcare providers. This will help ensure that beneficiaries have access to the care they need when they need it. Overall, the Medicare Advantage Consumer Protection and Transparency Act aims to protect and empower Medicare Advantage beneficiaries by increasing transparency, strengthening oversight, and improving access to care within the program.

Congressional Summary of HR 5854

Medicare Advantage Consumer Protection and Transparency Act

This bill generally requires Medicare Advantage organizations to report additional information to the Centers for Medicare & Medicaid Services, including supplemental plan benefits, encounter data, and the number of coverage denials and prior authorization requests. Failure to comply with the bill's requirements may result in payment reductions.

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Current Status of Bill HR 5854

Bill HR 5854 is currently in the status of Bill Introduced since September 29, 2023. Bill HR 5854 was introduced during Congress 118 and was introduced to the House on September 29, 2023. Bill HR 5854's most recent activity was Referred to the Subcommittee on Health. as of December 17, 2024

Bipartisan Support of Bill HR 5854

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Unaffiliated Sponsors

Total Number of Cosponsors

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Policy Area and Potential Impact of Bill HR 5854

Primary Policy Focus

Health

Alternate Title(s) of Bill HR 5854

Medicare Advantage Consumer Protection and Transparency ActMedicare Advantage Consumer Protection and Transparency ActTo amend title XVIII of the Social Security Act to require complete and accurate data set submissions from Medicare Advantage organizations offering Medicare Advantage plans under part C of the Medicare program to improve transparency, and for other purposes.

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