Bill > HR6110

This bill modifies existing Medicare Advantage (MA) plan regulations to change how coverage denials are reconsidered. Currently, Medicare Advantage plans require patients to request a reconsideration of a coverage denial, but this bill would mandate that plans automatically reconsider their own denials without waiting for a patient to submit a request. Specifically, the bill amends Section 1852(g)(2)(A) of the Social Security Act by replacing language that requires enrollees to request a reconsideration with a requirement that plans automatically review each determination denying coverage. The proposed change would start the reconsideration process on the date the initial coverage denial is made, potentially making it easier and faster for Medicare Advantage enrollees to challenge coverage decisions. This modification aims to provide more immediate and accessible appeals for patients who have been denied medical coverage by their Medicare Advantage plan.

Budget and Finance

https://www.congress.gov/bill/119th-congress/house-bill/6110/all-info