Bill > HR5243

This bill aims to increase transparency around supplemental benefits in Medicare Advantage (MA) plans by requiring MA organizations to submit detailed, enrollee-level data to the federal government. Starting in 2029, MA organizations will need to provide comprehensive information about supplemental benefits for each of their plans, including specifics on benefit eligibility, types of benefit categories, utilization data, and total spending per enrollee. Beginning in 2030, the Secretary of Health and Human Services will be required to make this data publicly accessible through two primary mechanisms: first, by releasing the data to researchers and program evaluators on the first Monday in October each year, and second, by publishing a public-use data file on the Centers for Medicare & Medicaid Services (CMS) website. The bill includes important privacy safeguards to protect individually identifiable enrollee information when the data is shared. This legislation is designed to provide greater insight into how Medicare Advantage plans are using and spending money on supplemental benefits, which could help policymakers, researchers, and the public better understand these healthcare plans.

Budget and Finance

https://www.congress.gov/bill/119th-congress/house-bill/5243/all-info