Medicare Advantage Prior Authorization Rules

Summary#

This bill would change Title XVIII of the Social Security Act to set requirements about how Medicare Advantage plans use prior authorization and deny claims. The text available to me lists the bill title, sponsors (Rep. Greg Landsman and Rep. Robert Onder), referral to the House Ways and Means and Energy and Commerce Committees, and that the bill is in progress. No full bill text or specific rule language is publicly available.

What it means for you#

If enacted, the bill would apply to Medicare Advantage plans and could affect people enrolled in those plans, the doctors and other providers who treat them, and the plans themselves. The bill’s exact changes, who must follow them, and the timelines are not publicly available.

Expenses#

No publicly available information about estimated costs, budget effects, or a Congressional Budget Office score.

Proponents' View#

No publicly available information describing supporters’ statements, intended benefits, or arguments in favor of the bill.

Opponents' View#

No publicly available information describing opponents’ statements, concerns, or arguments against the bill.