To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan.
Ways and Means Committee, Energy and Commerce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This bill proposes an amendment to title XVIII of the Social Security Act, specifically targeting Medicare Advantage (MA) plans. Its primary purpose is to enhance transparency by mandating that all advertisements for MA plans include detailed information regarding their prior authorization practices. This measure is intended to equip potential enrollees with crucial data to make more informed decisions about their healthcare coverage. Beginning one year after enactment, MA plan advertisements will be required to verbally and visually disclose several key metrics from the most recent plan year. These include the total number of prior authorization requests denied by the plan. Additionally, advertisements must specify the number of those denied requests that were later approved after reconsideration . Finally, the bill mandates the disclosure of the average number of days it took for these reconsidered requests to be approved, offering insight into the plan's appeals process efficiency.
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Timeline
Introduced in House
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.
Introduced in House
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 require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan.
USA119th CongressHR-6111| House
| Updated: 11/18/2025
This bill proposes an amendment to title XVIII of the Social Security Act, specifically targeting Medicare Advantage (MA) plans. Its primary purpose is to enhance transparency by mandating that all advertisements for MA plans include detailed information regarding their prior authorization practices. This measure is intended to equip potential enrollees with crucial data to make more informed decisions about their healthcare coverage. Beginning one year after enactment, MA plan advertisements will be required to verbally and visually disclose several key metrics from the most recent plan year. These include the total number of prior authorization requests denied by the plan. Additionally, advertisements must specify the number of those denied requests that were later approved after reconsideration . Finally, the bill mandates the disclosure of the average number of days it took for these reconsidered requests to be approved, offering insight into the plan's appeals process efficiency.
Get AI-generated questions to help you understand this bill better
Timeline
Introduced in House
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.
Introduced in House
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.