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.
The Medicare Advantage Improvement Act of 2026 is a bipartisan bill that reforms how Medicare Advantage insurance plans operate to improve patient access to care and increase transparency. Starting in 2028, the legislation requires plans to speed up authorization decisions for medical services (responding to standard requests within 72 hours and urgent ones within 24 hours), implement automated approval systems for routine procedures, streamline the appeals process for denied coverage (with decisions made within 30 days), and ensure patients receive notices and have time to submit additional medical evidence. The bill also establishes a new compliance scoring system that grades Medicare Advantage organizations on six performance categories and imposes financial penalties of 1.0 to 2.0 percent on underperforming plans, while preventing plans from denying payment for previously authorized services except in cases of fraud or good cause. Additionally, the legislation requires plans to establish adequate networks of long-term care and rehabilitation hospitals to ensure Medicare Advantage enrollees have sufficient access to specialized post-acute care facilities. These reforms aim to reduce delays in patient care, hold insurance plans accountable through public performance ratings, and protect beneficiaries from unfair coverage denials.
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