HR6111119th CongressWALLET

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.

Sponsored By: Representative Pocan

Introduced

Summary

Requires Medicare Advantage advertisements to disclose prior authorization denial rates and processing times. The bill would require advertisements for Medicare Advantage plans, starting one year after enactment, to include both spoken and visual disclosures for the most recent completed plan year showing the number of prior authorization requests denied (including those later approved on reconsideration), the number of those requests that were later approved on reconsideration, and the average number of days between the initial denial and approval for those reconsidered and approved. This disclosure aims to increase transparency so consumers can better compare plans and may affect how plans market benefits.

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Bill Overview

Analyzed Economic Effects

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

Medicare Advantage ads would show denials

If enacted, starting 1 year after enactment, Medicare Advantage ads would need spoken and on-screen disclosures when possible. The data would be from the most recent plan year that ended before the ad runs. Ads would state how many prior authorization requests the plan denied, including ones later approved. Ads would also state how many of those denials were later approved, and the average days from denial to approval.

Sponsors & CoSponsors

Sponsor

Pocan

WI • D

Cosponsors

  • Carson

    IN • D

    Sponsored 11/18/2025

  • Cohen

    TN • D

    Sponsored 11/18/2025

  • DeLauro

    CT • D

    Sponsored 11/18/2025

  • Doggett

    TX • D

    Sponsored 11/18/2025

  • Jayapal

    WA • D

    Sponsored 11/18/2025

  • Khanna

    CA • D

    Sponsored 11/18/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 11/18/2025

  • Ocasio-Cortez

    NY • D

    Sponsored 11/18/2025

  • Schakowsky

    IL • D

    Sponsored 11/18/2025

  • Takano

    CA • D

    Sponsored 11/18/2025

  • Thanedar

    MI • D

    Sponsored 11/18/2025

  • Tlaib

    MI • D

    Sponsored 11/18/2025

  • McBride

    DE • D

    Sponsored 11/18/2025

  • Omar

    MN • D

    Sponsored 11/18/2025

  • Dingell

    MI • D

    Sponsored 11/20/2025

  • Casar

    TX • D

    Sponsored 12/1/2025

  • Pingree

    ME • D

    Sponsored 12/16/2025

Roll Call Votes

No roll call votes available for this bill.

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