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Medicare Advantage Cost Transparency Act
To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data.
Summary
- Requires Medicare Advantage plans to include the allowed amount for each item or service in encounter data submitted starting January 1, 2027.
- Requires Medicare Advantage plans to include cost-sharing amounts (deductibles, copayments, coinsurance) for each item or service in encounter data.
- Requires Medicare Advantage plans to include an indicator if a beneficiary received an at-home health risk assessment from an assessment entity with a financial relationship to the plan.
- Requires Medicare Advantage plans to include a distinct indicator if a beneficiary received an at-home health risk assessment from an independent assessment entity without a financial relationship to the plan.
- Defines assessment entities as organizations focused on furnishing in-home health risk assessments as specified by the Secretary.
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)
- Rep. DeGette, Diana [D-CO-1] (D-CO)
1 cosponsor
- Rep. Joyce, John [R-PA-13] (R-PA)
Money behind the sponsor
Top reported contributors to Diana Degette’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- DAVITA $13,800
- DISH NETWORK $13,200
- BROWNSTEIN $7,350
- KEBD ENTERPRISES LLC $6,600
- PRIME POLICY GROUP $6,600
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Diana Degette → · Outside spending →
Actions (5)
- Jun 25, 2026 Forwarded by Subcommittee to Full Committee by Voice Vote. · house
- Jun 25, 2026 Subcommittee Consideration and Mark-up Session Held · house
- Jun 23, 2026 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
- Jun 23, 2026 Referred to the Subcommittee on Health. · house
- Jun 23, 2026 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Committee action
What happened to this bill in committee — the meetings where it was considered and every recorded vote taken on it.
Meetings where this bill was on the agenda
Full text
IN THE HOUSE OF REPRESENTATIVES
June 23, 2026
Ms. DeGette (for herself and Mr. Joyce of Pennsylvania) 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 require the inclusion of certain information in Medicare Advantage encounter data.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Medicare Advantage Cost Transparency Act”.
SEC. 2. REQUIRING THE INCLUSION OF CERTAIN INFORMATION IN ENCOUNTER DATA.
Section 1859 of the Social Security Act (42 U.S.C. 1395w-28) is amended by adding at the end the following new subsection:
“(j) Inclusion of Certain Information in Encounter Data.—
“(1) In general.—In the case of any encounter data submitted by a Medicare Advantage plan with respect to an item or service furnished to an individual under such plan during a plan year beginning on or after January 1, 2027, the Secretary shall require that such data include—
“(A) the allowed amount for such item or service;
“(B) the amount of cost sharing (including deductibles, copayments, and coinsurance) imposed for such item or service;
“(C) in the case such individual was furnished, during such plan year before such item or service was so furnished, an at-home health risk assessment from a specified assessment entity, an indicator that such individual was so furnished such an assessment by such an entity; and
“(D) in the case such individual was furnished, during such plan year before such item or service was so furnished, an at-home health risk assessment from an assessment entity not described in subparagraph (C), an indicator (distinct from the indicator described in such subparagraph) that such individual was so furnished such an assessment by such an entity.
“(2) Definitions.—In this subsection:
“(A) Assessment entity.—The term ‘assessment entity’ means an entity with a focus on furnishing in- home health risk assessments, as specified by the Secretary.
“(B) Specified assessment entity.—The term ‘specified assessment entity’ means, with respect to an MA organization and a plan year, an assessment entity with respect to which such organization (or any person with an ownership or control interest (as defined in section 1124(a)(3)) in such organization) is a person with an ownership or control interest (as so defined).”. <all>
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