# 119-hr-8375: Medicare Advantage Improvement Act of 2026 119-hr-8375, Medicare Advantage Improvement Act of 2026, is a 119th Congress bill sponsored by Rep. Joyce, John [R-PA-13] (R-PA); status introduced; PRIA reads it as touching household money (as of 2026-10-08). - Canonical: https://policyrisk.com/legislation/119-hr-8375 - As of: 2026-10-08 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: 119-hr-8375 - Congress: 119 - Title: Medicare Advantage Improvement Act of 2026 - Status: introduced - Introduced: 2026-04-20 - Sponsor: Rep. Joyce, John [R-PA-13] (R-PA) - Cosponsors: 24 - Policy area: Health - Touches household money: yes - Last recorded action: 2026-10-08 ## Summary **Faster prior authorizations and stronger plan accountability.** This bill would force Medicare Advantage plans to speed and standardize authorization decisions while creating a public compliance scoring program tied to payment adjustments and transparency rules. - Beneficiaries and providers would get quicker decisions. Plans must notify on prior authorization requests within 72 hours with one extension up to 7 days. Plans must also implement annual real‑time determination mechanisms for frequently approved, low‑risk services and report quarterly, provider‑level data to CMS for public release. - Medicare Advantage organizations would face a new Compliance Scoring and Accountability Program that rates plans on a 0–100 scale and places them in tiers. Poor performance can reduce monthly payments by up to 2.0% during the plan year and scores would be published for public review. - Claims, networks, and transparency would change. Prompt‑payment rules would apply to in‑network services. Plans must automate payment for certain authorized claims and meet new network adequacy standards for long‑term care hospitals and inpatient rehabilitation facilities. ## Cosponsors (24) - Rep. Carson, André [D-IN-7] (D-IN), 2026-10-06T00:00:00.000Z - Rep. Schrier, Kim [D-WA-8] (D-WA), 2026-04-20T00:00:00.000Z - Rep. Murphy, Gregory F. [R-NC-3] (R-NC), 2026-04-20T00:00:00.000Z - Rep. Panetta, Jimmy [D-CA-19] (D-CA), 2026-04-20T00:00:00.000Z - Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA), 2026-04-20T00:00:00.000Z - Rep. Bera, Ami [D-CA-6] (D-CA), 2026-04-20T00:00:00.000Z - Rep. Van Duyne, Beth [R-TX-24] (R-TX), 2026-04-20T00:00:00.000Z - Rep. Davis, Donald G. [D-NC-1] (D-NC), 2026-06-08T00:00:00.000Z - Rep. Mann, Tracey [R-KS-1] (R-KS), 2026-06-23T00:00:00.000Z - Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2026-06-23T00:00:00.000Z - Rep. Lawler, Michael [R-NY-17] (R-NY), 2026-06-23T00:00:00.000Z - Rep. Messmer, Mark B. [R-IN-8] (R-IN), 2026-06-25T00:00:00.000Z - Rep. Davids, Sharice [D-KS-3] (D-KS), 2026-06-25T00:00:00.000Z - Rep. Scott, Austin [R-GA-8] (R-GA), 2026-06-25T00:00:00.000Z - Rep. Carter, Troy A. [D-LA-2] (D-LA), 2026-07-09T00:00:00.000Z - Rep. Budzinski, Nikki [D-IL-13] (D-IL), 2026-07-09T00:00:00.000Z - Rep. Ciscomani, Juan [R-AZ-6] (R-AZ), 2026-07-09T00:00:00.000Z - Rep. Pfluger, August [R-TX-11] (R-TX), 2026-07-13T00:00:00.000Z - Rep. Schmidt, Derek [R-KS-2] (R-KS), 2026-07-20T00:00:00.000Z - Rep. Onder, Robert F. [R-MO-3] (R-MO), 2026-07-21T00:00:00.000Z - Rep. Goodlander, Maggie [D-NH-2] (D-NH), 2026-07-27T00:00:00.000Z - Rep. Sorensen, Eric [D-IL-17] (D-IL), 2026-08-10T00:00:00.000Z - Rep. Vasquez, Gabe [D-NM-2] (D-NM), 2026-08-13T00:00:00.000Z - Rep. Kean, Thomas H. [R-NJ-7] (R-NJ), 2026-08-13T00:00:00.000Z ## Provisions PRIA read - Faster authorizations and automatic payments: benefit, medium. If enacted, the bill would require faster decisions and more automatic payments for many prior authorizations beginning January 1, 2028. CMS would publish a yearly list of routine, low-risk services (items with at least 90% prior-authorization approval) that must get real-time decisions through cer… - Protections for approved care and appeals: benefit, medium. If enacted, the bill would limit retroactive denials and harder code changes for services that were approved during care starting January 1, 2028. Plans would not be able to require a new authorization when a provider makes a clinically necessary change or extension to an already-approved service.… - Better access to post-acute care: benefit, low. If enacted, the bill would require Medicare Advantage plans to meet new network adequacy standards that include long-term care hospitals and inpatient rehabilitation facilities for plan years starting January 1, 2028. The Secretary would set the specific network rules to ensure access to these post… - Medicare Advantage compliance scores and cuts: mixed, medium. If enacted, the bill would create a 0–100 compliance score for each Medicare Advantage organization and put each into a tier for plan years starting January 1, 2028. CMS would publish plan-level scores and let plans review data before publication. Plans in lower tiers would face monthly payment red… ## Related bills - 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act - 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025 - 119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025 - 119-hr-1262: Mikaela Naylon Give Kids a Chance Act - 119-hr-909: Crime Victims Fund Stabilization Act of 2025 - 119-hr-2102: Major Richard Star Act ## Sources - [119-hr-8375 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/8375) ## Related - [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842) - [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514) - [119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-879) - [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262) - [119-hr-909: Crime Victims Fund Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-909) - [119-hr-2102: Major Richard Star Act](https://policyrisk.com/legislation/119-hr-2102) - [All bills in Congress](https://policyrisk.com/legislation) Source: PRIA, https://policyrisk.com/legislation/119-hr-8375 (as of 2026-10-08).