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, Mark [D-WI-2]
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, 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
McBride
DE • 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.
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