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To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
Summary
- Requires Medicare Advantage organizations to submit enrollee-level data on supplemental benefits to the Secretary beginning with plan years on or after January 1, 2029.
- Requires data to include information on benefit eligibility, types of benefits offered, utilization of benefits, and payments for supplemental benefits per enrollee.
- Requires the Secretary to make this data available to individuals and entities for program evaluation, analysis, and health care research starting October 2030.
- Requires the Secretary to publish a public use data file containing supplemental benefits data on the Centers for Medicare and Medicaid Services website annually beginning October 2030.
- Requires the Secretary to establish safeguards to protect the privacy of individually identifiable enrollee information when making data available.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
1 cosponsor
Actions (5)
- Jun 25, 2026 Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote. · house
- Jun 25, 2026 Subcommittee Consideration and Mark-up Session Held · house
- Sep 10, 2025 Referred to the Subcommittee on Health. · house
- Sep 10, 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. · house
- Sep 10, 2025 Introduced in House
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Similar bills (6)
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Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
September 10, 2025
Ms. McClellan introduced the following bill; which was 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
A BILL
To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. INCREASING DATA TRANSPARENCY FOR SUPPLEMENTAL BENEFITS UNDER MEDICARE ADVANTAGE.
(a) In General.—Section 1857(e) of the Social Security Act (42 U.S.C. 1395w-27(e)) is amended by adding at the end the following new paragraph:
“(6) Reporting of enrollee-level data on supplemental benefits.—
“(A) In general.—Beginning with plan years beginning on or after January 1, 2029, a contract under this section with an MA organization shall require the organization to submit to the Secretary, for each MA plan offered by the organization, enrollee-level data on supplemental benefits (by item or service, or category of item or service, as determined appropriate by the Secretary, and national provider identifier), including eligibility for such benefits, the types of benefit categories offered, data on utilization of and payments for such benefits (including the total amount spent by the plan for each enrollee who utilized such benefits and the total out-of-pocket cost per utilization for each enrollee).
“(B) Data access.—
“(i) In general.—On the first Monday in October of each year (beginning with 2030), the Secretary shall make data submitted under subparagraph (A) available to individuals and entities for the purpose of conducting—
“(I) evaluations and other analysis to support the program under this title; and
“(II) other health care related research.
“(ii) Public use data file.—Not later than October 1 of each year (beginning with 2030), the Secretary shall make a public use data file containing the data submitted under subparagraph (A) available on the internet website of the Centers for Medicare & Medicaid Services.
“(iii) Confidentiality.—In making data available under this subparagraph, the Secretary shall have in place procedures to safeguard the privacy of any individually identifiable enrollee information.”.
(b) Rule of Construction.—Nothing in the amendments made by this section shall affect the collection of information as proposed pursuant to the notice entitled “Agency Information Collection Activities: Proposed Collection; Comment Request”, published in the Federal Register on March 14, 2023 (88 Fed. Reg. 15726). <all>
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