A
bipartisan
group
of
lawmakers
recently
introduced
companion
versions
of
the
Medicare
Advantage
Improvement
Act
of
2026
in
both
the
House
and
Senate,
aiming
to
strengthen
oversight
of
Medicare
Advantage.
The
bill
was
introduced
in
the
Senate
on
Monday
by
Senators
Roger
Marshall
(R-Kansas)
and
Sheldon
Whitehouse
(D-Rhode
Island).
It
was
introduced
last
week
in
the
House
by
Mariannette
Miller-Meeks
(R-Iowa),
John
Joyce
(R-Pennsylvania),
Greg
Murphy
(R-North
Carolina),
Jimmy
Panetta
(D-California),
Ami
Bera
(D-California),
Beth
Van
Duyne
(R-Texas)
and
Kim
Schrier
(D-Washington).
It
comes
as
Medicare
Advantage
enrollment
is
on
the
rise,
with
more
than
half
of
Medicare
beneficiaries
enrolled
in
Medicare
Advantage
plans.
However,
the
program
is
facing
increasing
scrutiny
over
care
delays
and
administrative
barriers.
Specifically,
the
bill
would:
-
Require
standard
prior
authorization
approvals
within
72
hours,
expedited
decisions
within
24
hours
and
real-time
approvals
for
routine
low-risk
services. -
Ban
coverage
from
being
retroactively
denied
once
a
service
is
authorized,
unless
there
is
fraud
or
error. -
Require
MA
plans
to
publicly
report
prior
authorization
data. -
Ban
MA
plans
from
applying
stricter
medical
necessity
standards
than
original
Medicare. -
Strengthen
network
adequacy
requirements
for
rehabilitation
hospitals
and
long-term
care
hospitals.
“Americans
are
rightfully
fed
up
with
health
care
bureaucracy,
and
prior
authorization
is
one
of
the
worst
offenders:
delaying
treatment,
driving
up
costs,
and
putting
paperwork
ahead
of
patients.
We
need
to
cut
this
red
tape
so
providers
can
deliver
timely,
high-quality
care,”
Sen.
Whitehouse
said
in
a
statement.
Rep.
Miller-Meeks
echoed
these
comments.
“For
too
long,
cases
of
abuse
have
crept
into
Medicare
Advantage,
pulling
it
away
from
its
core
mission
of
serving
America’s
seniors,”
said
Miller-Meeks
in
a
statement.
“As
a
physician,
I’ve
seen
how
these
practices
delay
care,
create
unnecessary
barriers,
and
increase
the
cost
of
healthcare.
This
bill
restores
accountability,
cracks
down
on
bad
actors,
and
ensures
Iowa
seniors
can
access
the
care
they
need,
without
delay,
without
denial,
and
without
interference
from
bureaucratic
red
tape.”
The
American
Health
Care
Association
and
National
Center
for
Assisted
Living
applauded
the
introduction
of
the
bill.
“The
Medicare
Advantage
Improvement
Act
of
2026
represents
a
significant
step
towards
ensuring
Medicare
Advantage
delivers
on
its
promise
to
America’s
seniors,”
said
Clif
Porter,
president
and
CEO
of
AHCA/NCAL,
in
a
statement.
“We
commend
these
lawmakers
for
developing
a
better
way
to
enable
seniors
to
have
timely
access
to
care
and
hold
plans
accountable.
We
urge
continued
bipartisan
support
and
swift
passage
through
Congress.”
Photo:
designer491,
Getty
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