Bill > S2879

This bill aims to improve the prompt payment requirements for Medicare Advantage (MA) organizations, which are private health insurance plans that provide Medicare benefits. The bill mandates that MA organizations must pay at least 95% of "clean claims" (claims with complete and accurate information) within specific timeframes: 14 days for electronically submitted claims and 30 days for paper claims. If these organizations fail to pay claims within the specified deadlines, they must pay interest to the healthcare provider at a standard federal interest rate. Additionally, the bill introduces civil money penalties of up to $25,000 for MA organizations that consistently fail to meet these prompt payment requirements. The bill also requires MA organizations to report detailed information about their claims processing, including the number of claims submitted, paid, and the amount of interest paid. These new requirements will take effect on January 1, 2027, giving healthcare providers and MA organizations time to prepare for the changes. The goal of this legislation is to ensure timely and accurate payment for medical services, reduce administrative burdens, and improve transparency in the Medicare Advantage system.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/2879/all-info