Medicare Advantage Prompt Pay Act
Sponsored By: Senator Catherine Cortez Masto
Introduced
Summary
Prompt-payment standards for Medicare Advantage claims. This bill would require faster payments to providers and create penalties and interest for plans that miss deadlines.
Show full summary
- Providers and suppliers would see faster payment timelines for covered services. Plans would have to pay clean claims in 14 days for electronic submissions and 30 days for non-electronic submissions.
- Medicare Advantage organizations would be required to pay at least 95 percent of clean claims and would face civil money penalties up to $25,000 for each noncompliance determination, plus interest at the federal prompt-payment penalty rate for late payments.
- Plans would have to report compliance data for the most recent 12-month period, including the number and percent of claims paid, whether claims were under contract, on-time payment rates, and total interest paid.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Faster payments by Medicare Advantage plans
If enacted, Medicare Advantage plans would need to pay at least 95% of clean claims within set deadlines. The deadline would be 14 days for electronic claims sent by contracted providers. The deadline would be 30 days for other claims. If a clean claim is late, the plan would owe interest at the rate used under 31 U.S.C. 3902(a). Plans would also report 12 months of data on claims paid, timeliness, interest paid, and total interest amounts. The Secretary could fine plans up to $25,000 for each finding of noncompliance. These rules would apply to items and services furnished on or after January 1, 2027. They would also apply to contract years beginning on or after that date.
Sponsors & CoSponsors
Sponsor
Catherine Cortez Masto
NV • D
Cosponsors
Marsha Blackburn
TN • R
Sponsored 9/18/2025
Adam Schiff
CA • D
Sponsored 3/18/2026
Roll Call Votes
No roll call votes available for this bill.
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