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To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

USA119th CongressHR-5243| House 
| Updated: 9/10/2025
Jennifer L. McClellan

Jennifer L. McClellan

Democratic Representative

Virginia

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill, H.R. 5243, aims to significantly increase data transparency for supplemental benefits offered through Medicare Advantage plans. It amends the Social Security Act to require Medicare Advantage organizations to submit detailed, enrollee-level data on these benefits to the Secretary of Health and Human Services, beginning with plan years starting on or after January 1, 2029. The required data includes information on eligibility , the types of benefit categories offered , and comprehensive details on utilization and payments , such as the total amount spent per enrollee and out-of-pocket costs per utilization. This granular data will be reported by item or service, or category, and include national provider identifiers. To ensure public access and utility, the bill mandates that the Secretary make this submitted data available annually to individuals and entities for program evaluations and healthcare research, starting in October 2030. Furthermore, a public use data file containing this information must be published on the Centers for Medicare & Medicaid Services website, with strict procedures in place to safeguard the privacy of any individually identifiable enrollee information.
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Timeline

Bill from Previous Congress

HR 118-5380
To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
Sep 10, 2025
Introduced in House
Sep 10, 2025
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  • Bill from Previous Congress

    HR 118-5380
    To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.


  • September 10, 2025
    Introduced in House


  • September 10, 2025
    Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Health

To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

USA119th CongressHR-5243| House 
| Updated: 9/10/2025
This bill, H.R. 5243, aims to significantly increase data transparency for supplemental benefits offered through Medicare Advantage plans. It amends the Social Security Act to require Medicare Advantage organizations to submit detailed, enrollee-level data on these benefits to the Secretary of Health and Human Services, beginning with plan years starting on or after January 1, 2029. The required data includes information on eligibility , the types of benefit categories offered , and comprehensive details on utilization and payments , such as the total amount spent per enrollee and out-of-pocket costs per utilization. This granular data will be reported by item or service, or category, and include national provider identifiers. To ensure public access and utility, the bill mandates that the Secretary make this submitted data available annually to individuals and entities for program evaluations and healthcare research, starting in October 2030. Furthermore, a public use data file containing this information must be published on the Centers for Medicare & Medicaid Services website, with strict procedures in place to safeguard the privacy of any individually identifiable enrollee information.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 118-5380
To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
Sep 10, 2025
Introduced in House
Sep 10, 2025
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  • Bill from Previous Congress

    HR 118-5380
    To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.


  • September 10, 2025
    Introduced in House


  • September 10, 2025
    Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jennifer L. McClellan

Jennifer L. McClellan

Democratic Representative

Virginia

Ways and Means Committee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted