Medicare Advantage Prompt Pay Act
Sponsored By: Representative Arrington
Introduced
Summary
Require Medicare Advantage organizations to pay most clean claims quickly. This bill would set a 95% prompt-payment standard and deadlines of 14 days for electronic claims and 30 days for other claims. It would add interest for late payments, civil money penalties, and new reporting on plan payment performance.
Show full summary
- Providers and suppliers would get faster, more predictable payments under plan contracts and could collect interest when clean claims miss the deadline.
- Medicare Advantage organizations would have to meet a 95% on-time payment target and could face civil money penalties up to $25,000 per determination for noncompliance.
- Plans would report 12 months of metrics on claims paid, shares of in-contract versus out-of-contract payments, how many met the deadlines, and the total interest paid.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Faster pay for Medicare Advantage providers
If enacted, Medicare Advantage plans would have to pay at least 95% of clean claims on time. Electronic claims would be paid within 14 days; other claims within 30 days. Late payments would include interest from the day after the due date until paid. A claim is clean if it has all required data and, for e-claims, meets federal standards. Receipt would be presumed on the e-verification date, or the 5th business day after postmark or timestamp. The Secretary could fine plans up to $25,000 per determination. Plans would report 12-month prompt-pay metrics, including on-time rates and interest paid, for contracted and non-contracted claims. These rules would start January 1, 2027.
Sponsors & CoSponsors
Sponsor
Arrington
TX • R
Cosponsors
Sanchez
CA • D
Sponsored 9/18/2025
Veasey
TX • D
Sponsored 9/19/2025
Miller (WV)
WV • R
Sponsored 9/26/2025
Yakym
IN • R
Sponsored 12/4/2025
Moran
TX • R
Sponsored 2/20/2026
Pfluger
TX • R
Sponsored 2/23/2026
Thompson (CA)
CA • D
Sponsored 3/24/2026
Roll Call Votes
No roll call votes available for this bill.
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