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Increased Transparency and Protection for Medicare Advantage Users

New regulations aim to increase transparency in Medicare Advantage insurance programs. Insurance companies will be required to provide more detailed data on benefits, costs, and denials, making it easier for citizens to compare offers and make informed decisions about their healthcare. Failure to provide complete data will result in financial penalties for insurers.
Key points
Medicare Advantage organizations will be required to disclose detailed data on supplemental benefits, including their type, number of beneficiaries, and expenditures.
Financial penalties are introduced for companies that fail to submit complete and accurate data on benefits and encounters.
Insurers will have to report data on coverage denials and prior authorization requirements, increasing transparency in these processes.
Information on provider networks (doctors, hospitals) in Medicare Advantage plans will be publicly available and regularly updated, making it easier to find a suitable specialist.
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Additional Information
Print number: 117_HR_9019
Sponsor: Rep. Porter, Katie [D-CA-45]
Process start date: 2022-09-28