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, Jennifer L. [D-VA-4]

In Committee

Summary

This bill would require enrollee-level reporting of Medicare Advantage supplemental benefits so policymakers and the public can see who gets extra services and what plans spend. It sets phased start dates, requires public-use files, and demands privacy protections.

Show full summary
  • Families and enrollees: Data would show which supplemental benefits each enrollee is eligible for and uses, plus the total plan spending and the out-of-pocket cost per use.
  • Medicare Advantage plans: Plans would have to submit enrollee-level records by item or category, including national provider identifiers, utilization counts, and payment amounts, beginning with plan years starting January 1, 2029.
  • Researchers and policymakers: CMS would make submitted data available for evaluation and other research and publish a public-use file by October 1, 2030, while implementing confidentiality procedures to protect identifiable information.

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Bill Overview

Analyzed Economic Effects

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

More Medicare Advantage benefit data

If enacted, the bill would require each Medicare Advantage plan to submit person-level data on supplemental benefits starting with plan years beginning on January 1, 2029. The data would include items or service categories (as the Secretary requires), provider national provider identifier, eligibility for benefits, the types of benefit categories offered, utilization and payment details, the total amount the plan spent for each enrollee who used such benefits, and each enrollee's out-of-pocket cost per use. If enacted, the Secretary would make the submitted data available to researchers and program evaluators on the first Monday in October each year starting in 2030 and publish a public-use data file on the CMS website by October 1, 2030 and each year after. The Secretary would implement confidentiality procedures to protect individually identifiable enrollee information, and the bill would not affect the information collection described in the Federal Register notice published March 14, 2023 (88 Fed. Reg. 15726).

Sponsors & CoSponsors

Sponsor

McClellan, Jennifer L. [D-VA-4]

VA • D

Cosponsors

  • Rep. Wittman, Robert J. [R-VA-1]

    VA • R

    Sponsored 7/16/2026

Roll Call Votes

No roll call votes available for this bill.

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