Medicare Advantage Integrity Act of 2025
Congress Bill Sets Medicare Advantage Payment Floor Starting in 2026, Ties Half of Any Increase to Basic Benefits
Stalled
No legislative action in over 90 days.
Legislative Progress
Key Points
- Sets a minimum adjustment level for Medicare Advantage payment benchmarks starting in 2026, so some areas can’t fall below that floor.
- This mainly affects places where traditional Medicare use is low, which can lead to lower Medicare Advantage benchmarks under current calculations.
- Requires Medicare Advantage plans to use at least half of any extra payment from this change on basic covered services (the core medical benefits).
- Could raise payments to Medicare Advantage plans in certain regions, which may influence what plans offer and what providers get paid in those areas.
Impact Analysis
Personal Impact
How this policy affects specific groups of people
Milestones
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
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Nota sobre la radicación del Medicare Advantage Integrity Act (H.R. 6031) y el objetivo de asegurar pagos más equitativos; incluye el requisito de destinar una parte del aumento a beneficios básicos.
Source Information
Document Type
Congressional Bill
Official Title
Medicare Advantage Integrity Act of 2025
Data Sources
Sponsor
Cosponsors
(2)Analysis generated by AI. Always verify with official sources.