"The bills fall under three categories: 1. Delays and denials of care Denials Don't Pay Act: Disincentivizes MA plans from delaying and denying care through prior authorization requirements Right to Appeal Patient Insurance Denials Act: Helps patients receive needed care by automatically appealing denials Disclose Your Denials Act: Requires MA plans to disclose their delay and denial rates when advertising 2. Overcharging taxpayers Medicare Advantage Fraud Accountability Act: Bans companies from participating in MA if they've been convicted of defrauding the government Keep Medicare Costs Down Act: Requires MA plans to charge the government per beneficiary as much as or less than traditional Medicare Seniors' Choice and Clarity Act: Limits the number of plans that MA companies can provide to just three a year 3. Strengthening traditional Medicare Protecting Medicare Choice Act: Prevents Medicare Advantage from being set as the default option for seniors, which was proposed in Project 2025 Find My Doctor Act: Requires CMS to create a national website that allows people to search for doctors by plan"
""Only Medicare is Medicare. It is one of the most popular and important services our government provides," Pocan said in a statement. "But for too long, private healthcare companies taking advantage of Medicare's brand and popularity have tricked and"
Thirteen Democratic House members introduced a package of eight bills aimed at reining in Medicare Advantage (MA) practices and reinforcing traditional Medicare. The proposals target three problem areas: delays and denials of care through prior authorization and automatic appeals, overcharging taxpayers by banning fraud-convicted firms and requiring MA payments to match or beat traditional Medicare rates, and strengthening traditional Medicare by preventing MA default enrollment and creating a national doctor-search website. Specific measures include disclosure of denial rates, limits on the number of plans offered, and prohibiting MA as the default option for seniors.
Read at MedCity News
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