A new piece of legislature might ease Medicare Advantage reimbursement struggles for providers.
Providers have struggled with Medicare Advantage Plan payments, but now new legislation might ease some of the struggle.
The Medicare Advantage Prompt Pay Act, introduced in both chambers of Congress, is aiming to help providers contracted with Medicare Advantage plans and ensure that seniors in particular aren't stuck with confusing bills.
A letter by the American Hospital Association (AHA) in support of the bill said there are currently no existing prompt payment standards that require MA plans to provide timely payment to contracted providers. While most states have some type of prompt payment laws regulating fully insured and other state-regulated insurance types, these laws do not apply to MA plans, the AHA said in the letter.
The 2025 Omniscient Health Physician Medicare Income Report, released in August, found that Medicare Advantage plans pay physicians an estimated 10% to 15% less than what is paid by the government in traditional Medicare.
Check out this infographic for four key takeaways on the new bill.
Marie DeFreitas is the CFO editor for HealthLeaders.