A Republican bill with 2 Democratic cosponsors · See all 3 cosponsors
Last activity — Read twice and referred to the Committee on Finance.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The Medicare Advantage Improvement Act of 2026 aims to reform the Medicare Advantage program by updating the Social Security Act. The bill focuses on speed, requiring Medicare Advantage organizations to respond to authorization requests more quickly. It introduces real-time authorization mechanisms for specific services and improves the transparency of prior authorization data. Additionally, the act establishes a compliance scoring and accountability program to penalize organizations that fail to meet certain standards. It also limits the ability of organizations to deny coverage or reduce payments for previously approved services. Finally, the bill updates medical necessity criteria and network adequacy standards.
Yes· 3 of 7
- Scored +8
Would people over 65 be better off under this?
The bill reduces delays in care and prevents unexpected coverage denials for Medicare Advantage enrollees.
- Scored +7
Does this make health care easier to get in general?
The bill mandates faster response times for authorizations and real-time decision-making for specified services.
- Scored +6
Does this strengthen Social Security?
The bill strengthens the Medicare Advantage program by increasing transparency and oversight of coverage decisions.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Faster Care Access: Medicare Advantage organizations must respond to specified authorization requests within 72 hours, and expedited requests must be addressed within 24 hours (Section 2(a)).
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Real-Time Approvals: For certain identified services, organizations must provide real-sime determinations and automated approvals through interoperable electronic health record technology (Section 2(b)).
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Protection Against Denials for Necessary Changes: If a provider determines a modification or extension to an approved service is clinically necessary, the organization cannot require a new authorization (Section 2(c)).
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Faster Appeals Process: The bill reduces the timeframe for organizations to submit case files during the reconsideration process to as little as 14 days (Section 2(d)).
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Consistent Medical Necessity Standards: Medicare Advantage organizations cannot apply medical necessity criteria that are more restrictive than the standards used in Original Medicare (Section 5(b)).
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Increased Transparency: Organizations are required to make coverage criteria and prior authorization data publicly available, providing better oversight for patients and researchers (Section 2(a) and Section 5(c)).
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Guaranteed Payment for Approved Services: Once an item or service is authorized, the organization cannot deny coverage or reduce payment amounts later, except for good cause or fraud (Section 4(b)).
Potential Negative Impacts for People
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Potential for Deadline Extensions: Medicare Advantage organizations may extend the 72-hour response deadline by up to 7 days under specific circumstances, such as needing more medical evidence (Section 2(a)).
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Secretarial Authority to Change Deadlines: The Secretary has the power to change the established response deadlines through rulemaking (Section 2(a)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people over 65 be better off under this? — The bill reduces delays in care and prevents unexpected coverage denials for Medicare Advantage enrollees. Would veterans be better off under this, taking everything together? — The bill improves medical service access and reduces administrative barriers for Medicare enrollees, including veterans. Would households on low incomes be better off under this? — Improved healthcare access through faster authorization processes benefits low-income individuals relying on Medicare Advantage.
- Healthcare
- Does this make health care easier to get in general? — The bill mandates faster response times for authorizations and real-time decision-making for specified services. Does this put more money into Medicare, the health coverage for people over 65? — The bill improves service access and protections for Medicare Advantage enrollees through stricter organizational accountability.
- Social Issues And Justice
- Does this strengthen Social Security? — The bill strengthens the Medicare Advantage program by increasing transparency and oversight of coverage decisions.
- Economy And Finance
- Does this make it easier to run a small business? — The bill implements stricter prompt payment requirements for Medicare Advantage organizations.
- 6/15/2026
- 2 Cosponsors added.
- 4/27/2026
- Read twice and referred to the Committee on Finance.
- 1 Cosponsor added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Christopher CoonsDemocrat · Delaware
James LankfordRepublican · Oklahoma
Sheldon WhitehouseDemocrat · Rhode Island