Bill > HR6031

This bill aims to establish a minimum geographic adjustment rate for Medicare Advantage (MA) payments in regions with low Medicare fee-for-service (FFS) penetration. Specifically, the bill mandates that starting in 2026, the average geographic adjustment for calculating Medicare Advantage base payment amounts cannot be less than 0.70 in any geographic area. The Secretary of Health and Human Services is granted discretion to define the "average geographic adjustment" through program instructions. Additionally, the bill requires that at least 50% of any increased benchmark payments resulting from this adjustment must be directed toward basic healthcare benefits for patients. The goal is to address disparities in Medicare Advantage benchmark rates across different regions, ensuring that areas with lower Medicare fee-for-service participation receive more equitable funding. By setting a floor for geographic adjustments and mandating that increased payments support direct patient care, the bill seeks to improve healthcare access and affordability for Medicare Advantage beneficiaries in underserved areas.

Budget and Finance

https://www.congress.gov/bill/119th-congress/house-bill/6031/all-info