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Faster Payments for Medicare Advantage Providers

This act aims to speed up payments to doctors and hospitals working with Medicare Advantage plans. This means providers will receive money faster for medical services, potentially improving their financial stability and patient access to care. It also introduces financial penalties for Medicare Advantage organizations that fail to meet payment deadlines.
Key points
Medicare Advantage plans must pay at least 95% of "clean claims" within 14 days (electronic) or 30 days (paper).
If payment is not made on time, Medicare Advantage organizations will have to pay interest to providers.
Financial penalties of up to $25,000 will be imposed on organizations that consistently miss payment deadlines.
Medicare Advantage organizations will be required to report data on payment timeliness, increasing transparency.
These changes will take effect from January 1, 2027.
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Status:
Introduced
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Additional Information
Medicare Advantage Prompt Pay Act
Print number: HR 5454
Sponsor: Rep. Arrington, Jodey C. [R-TX-19]
Process start date: 2025-09-18