Increased Transparency for Costs and Services in Medicare Advantage Plans.
This law requires Medicare Advantage (MA) plans to provide the government with much more detailed information about the services they cover, including the actual cost, how the plan paid the provider, and the patient's out-of-pocket expenses. The goal is to increase transparency in how these plans operate and better monitor the use of public funds. These changes, effective from 2026, may influence future healthcare quality and oversight of MA plans.
Key points
MA plans must disclose detailed payment methods used for providers (e.g., fee-for-service vs. capitation).
Mandatory reporting of exact amounts patients pay out-of-pocket (deductibles, copayments, and coinsurance).
Increased scrutiny on how and by whom in-home health risk assessments are conducted, which is relevant to plan funding.
Expired
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