To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage.
Sponsored By: Representative Pocan, Mark [D-WI-2]
Introduced
Summary
Requires automatic reconsideration of every Medicare Advantage coverage denial without an enrollee request. It ties that automatic reconsideration to the date the original denial was made.
Show full summary
- Medicare Advantage enrollees: Would not have to ask for a second review when a plan denies coverage. Each denial would be reconsidered automatically on the date of the initial determination.
- Medicare Advantage plans: Would be required to perform automatic reconsiderations for every denial, by changing the law to apply reconsideration to "each determination."
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Automatic review of Medicare Advantage denials
This bill would require Medicare Advantage plans to automatically reconsider every coverage denial. You would not need to file a reconsideration request. The reconsideration would start on the date the plan made the denial.
Sponsors & CoSponsors
Sponsor
Pocan, Mark [D-WI-2]
WI • D
Cosponsors
Carson
IN • D
Sponsored 11/18/2025
Cohen
TN • D
Sponsored 11/18/2025
Rep. DeLauro, Rosa L. [D-CT-3]
CT • D
Sponsored 11/18/2025
Rep. Doggett, Lloyd [D-TX-37]
TX • D
Sponsored 11/18/2025
Rep. Jayapal, Pramila [D-WA-7]
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
Rep. Takano, Mark [D-CA-39]
CA • D
Sponsored 11/18/2025
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 11/18/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 11/18/2025
Rep. Bell, Wesley [D-MO-1]
MO • D
Sponsored 11/18/2025
Rep. Omar, Ilhan [D-MN-5]
MN • D
Sponsored 11/18/2025
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 11/20/2025
Rep. Casar, Greg [D-TX-35]
TX • D
Sponsored 12/1/2025
Pingree
ME • D
Sponsored 12/16/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov