HR5243119th CongressWALLET

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

Sponsored By: Representative McClellan

Introduced

Summary

Enrollee-level reporting of Medicare Advantage supplemental benefits would require plans to submit detailed, per-enrollee data on extra services, use, payments, and provider identifiers to support transparency and research. This reporting would start with plan years beginning January 1, 2029, and annual public files would be released beginning in 2030.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Public data on Medicare Advantage benefits

Starting with plan years on or after January 1, 2029, Medicare Advantage plans would have to submit enrollee-level data on supplemental benefits. Data would include the item or service (or category), the provider ID, who was eligible, the types offered, use, what the plan spent per enrollee who used a benefit, and the out-of-pocket cost per use. Beginning in 2030, HHS would make these data available each year on the first Monday in October for research, and post a public-use file by October 1 on the CMS website. The agency would have to safeguard privacy. This would not change a separate data collection proposed in March 2023.

Sponsors & CoSponsors

Sponsor

McClellan

VA • D

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

No roll call votes available for this bill.

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