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Medicare Advantage Integrity Act of 2025

USA119th CongressHR-6031| House 
| Updated: 11/12/2025
Pablo Jose Hernández

Pablo Jose Hernández

Democratic Representative

Puerto Rico

Cosponsors (2)
Darren Soto (Democratic)Maria Elvira Salazar (Republican)

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill establishes a minimum average geographic adjustment of 0.70 for Medicare Advantage benchmark rates, effective for 2026 and subsequent years. This provision aims to address payment disparities in regions characterized by low Medicare fee-for-service penetration, ensuring a baseline funding level for plans. The legislation further mandates that at least 50 percent of any increase in the blended benchmark amount, directly attributable to this new floor, must be allocated towards payment for basic benefits . This ensures that additional funds are specifically directed to support essential care and services for Medicare Advantage beneficiaries. The Secretary is authorized to define the term "average geographic adjustment" for implementation.
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Timeline

Bill from Previous Congress

HR 117-1969
Medicare Advantage Integrity Act

Bill from Previous Congress

HR 118-4411
Medicare Advantage Integrity Act of 2023
Nov 12, 2025
Introduced in House
Nov 12, 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 117-1969
    Medicare Advantage Integrity Act


  • Bill from Previous Congress

    HR 118-4411
    Medicare Advantage Integrity Act of 2023


  • November 12, 2025
    Introduced in House


  • November 12, 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

Medicare Advantage Integrity Act of 2025

USA119th CongressHR-6031| House 
| Updated: 11/12/2025
This bill establishes a minimum average geographic adjustment of 0.70 for Medicare Advantage benchmark rates, effective for 2026 and subsequent years. This provision aims to address payment disparities in regions characterized by low Medicare fee-for-service penetration, ensuring a baseline funding level for plans. The legislation further mandates that at least 50 percent of any increase in the blended benchmark amount, directly attributable to this new floor, must be allocated towards payment for basic benefits . This ensures that additional funds are specifically directed to support essential care and services for Medicare Advantage beneficiaries. The Secretary is authorized to define the term "average geographic adjustment" for implementation.
View Full Text

Suggested Questions

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

Timeline

Bill from Previous Congress

HR 117-1969
Medicare Advantage Integrity Act

Bill from Previous Congress

HR 118-4411
Medicare Advantage Integrity Act of 2023
Nov 12, 2025
Introduced in House
Nov 12, 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 117-1969
    Medicare Advantage Integrity Act


  • Bill from Previous Congress

    HR 118-4411
    Medicare Advantage Integrity Act of 2023


  • November 12, 2025
    Introduced in House


  • November 12, 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.
Pablo Jose Hernández

Pablo Jose Hernández

Democratic Representative

Puerto Rico

Cosponsors (2)
Darren Soto (Democratic)Maria Elvira Salazar (Republican)

Ways and Means Committee, Energy and Commerce Committee

Health

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