Bill · H.R. 5454· House(119-HR-5454)

Medicare Advantage Prompt Pay Act

Age: 54 years

Texas

Introduced: 9/18/2025
Last activity: 9/18/2025 — 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.
Sponsored by: Jodey Arrington
Cosponsors: - 11 - 9

Health

Introduced
In Committee

What this bill would do

The Medicare Advantage Prompt Pay Act aims to amend the Social Security Act to improve payment timelines for Medicare Advantage organizations. The bill requires these organizations to provide prompt payment for at least 95 percent of clean claims submitted by providers or suppliers. It establishes specific deadlines of 14 days for electronic claims under contract and 30 days for all other claims. To ensure compliance, the bill mandates interest payments for delayed clean claims. Additionally, it introduces civil money penalties for organizations that fail to comply with these requirements. These changes are intended to take effect for services furnished on or after January 1, 2027.

Yes· 3 of 6

Would business owners be better off under this?+6
Healthcare providers and suppliers benefit from the mandated prompt payment and interest on late payments.
Does this make what the government does easier for the public to see?+5
The bill requires Medicare Advantage organizations to report detailed compliance and payment data.
Does this make health care easier to get in general?+5
By ensuring faster payments to providers, it supports the financial stability of healthcare service delivery within Medicare Advantage.