Bipartisan Legislation Aims to Improve Medicare Advantage's Billing Practices

Strategic Insights -

U.S. Senators Marsha Blackburn and Catherine Cortez Masto introduced the Medicare Advantage Prompt Pay Act, a bipartisan, bicameral legislation aimed at enhancing Medicare Advantage's billing practices. The legislation aims to provide certainty to health care providers who contract with MA plans, ensuring that seniors are not burdened by unfair or overdue bills. Companion legislation in the U.S. House of Representatives is led by Representatives Jodey Arrington and Linda Sanchez.

Key Takeaways:

  • The Medicare Advantage Prompt Pay Act aims to improve Medicare Advantage's billing practices, providing certainty to health care providers and ensuring that seniors are not burdened by unfair or overdue bills.
  • The legislation is endorsed by several prominent healthcare organizations, including the Federation of American Hospitals (FAH), American Hospital Association (AHA), and National Rural Health Association (NRHA).
  • More than half of seniors eligible for Medicare are enrolled in Medicare Advantage, but many are hit with confusing medical bills due to delayed and inconsistent Medicare Advantage billing practices.
  • The bill would require Medicare Advantage plans to pay hospitals and doctors on time or face penalty, bringing transparency and stability to the program.
  • Representative Jodey Arrington stated that Medicare Advantage plans are delaying payments to rural hospitals and providers, resulting in service cuts, staff shortages, forced closures, and patients with unexpected medical bills.
  • The legislation is supported by hospital associations from multiple states, including Nevada, Texas, and California.
  • The bill aims to protect patients, support the hospitals and doctors who care for them, and ensure Medicare Advantage works as intended.

Statistics:

  • More than half of seniors eligible for Medicare (52% or approximately 22 million people) are enrolled in Medicare Advantage (Source: Centers for Medicare and Medicaid Services).
  • Medicare Advantage plans are delaying payments to rural hospitals and providers, resulting in service cuts, staff shortages, forced closures, and unexpected medical bills (Source: Representative Jodey Arrington).
  • Approximately 16,000 Nevadans are employed by 38 FAH member facilities across the state (Source: Federation of American Hospitals).

Sources:

  • U.S. Senators Marsha Blackburn (R-Tenn.) and Catherine Cortez Masto (D-Nev.) (Press Release)
  • Representatives Jodey Arrington (R-Texas-19) and Linda Sanchez (D-Calif.-38) (Press Release)
  • Federation of American Hospitals (FAH) Executive Vice President of Public Affairs, Charlene MacDonald
  • Nevada Hospital Association, American Hospital Association (AHA), National Rural Health Association (NRHA)