Rep. Arrington Introduces Bill to Force Medicare Advantage Plans to Pay Doctors Faster

From policy text

“A contract under this part between the Secretary and a Medicare Advantage organization offering a Medicare Advantage plan shall require the organization to provide prompt payment for not less than 95 percent of clean claims submitted to the organization, with respect to covered items or services furnished to enrollees by a provider of services or supplier, within the applicable number of calendar days after the date of initial receipt of such clean claim”

From policy text

“the MA organization shall pay the provider of services or supplier interest at the rate used for purposes of section 3902(a) of title 31, United States Code (relating to interest penalties for failure to make prompt payments) for the period beginning on the day after such required payment date and ending on the date on which payment is made”

From policy text

“If the Secretary determines that an MA organization with a contract under this section is not in compliance with subsection (f)(1), the Secretary shall provide, in addition to any other remedies authorized by law, for civil money penalties of not more than $25,000 for each such determination.”

From policy text

“information regarding compliance of the plan with the prompt payment requirements under section 1857(f)(1), including, with respect to the most recent 12-month period for which data are available”

From policy text

“The amendments made by this subsection shall apply with respect to items and services furnished on or after January 1, 2027, and contract years beginning on or after such date.”