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Medicare Advantage MLR Transparency Act
To amend title XVIII of the Social Security Act to promote transparency of Medicare Advantage plan information.
Summary
- Requires Medicare Advantage organizations to submit and publish detailed financial information about each plan starting January 1, 2029, including total revenue and breakdown of spending.
- Requires disclosure of the amount and percentage of revenue spent on claims (medical costs) and non-claims costs (overhead) for each Medicare Advantage plan.
- Requires disclosure of the difference between the Medical Loss Ratio numerator and denominator, expressed both as a dollar amount and as a percentage of revenue.
- Requires the Secretary of Health and Human Services to specify a consumer-friendly format for publishing this financial information, which may include aggregate data across all plans offered by an organization.
- Requires Medicare Advantage benefit information to be presented in the same uniform format as required for other health insurance plans and group health plans under existing law.
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)
Money behind the sponsor
Top reported contributors to Nathaniel Moran’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- NULL $50,200
- DRAKE $13,200
- LEDWELL & SONS ENTERPRISES, INC. $9,900
- PELTIER AUTO GROUP $9,500
- CITIZENS 1ST BANK $7,100
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Nathaniel Moran → · Outside spending →
Actions (4)
- Jul 15, 2026 Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 42 - 0. · house
- Jul 15, 2026 Committee Consideration and Mark-up Session Held · house
- Jul 13, 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
- Jul 13, 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.
Full text
IN THE HOUSE OF REPRESENTATIVES
July 13, 2026
Mr. Moran 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 promote transparency of Medicare Advantage plan information.
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 MLR Transparency Act”.
SEC. 2. PROMOTING TRANSPARENCY OF MEDICARE ADVANTAGE PLAN INFORMATION.
(a) Overhead Costs and Claim Payment Information.—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:
“(7) Overhead costs and claim payment information.—
“(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, with respect to each MA plan offered by such organization during such plan year, to submit to the Secretary and publish on the public website of such organization the following information in a consumer- friendly format specified by the Secretary:
“(i) The amount of total revenue (as determined in accordance with section 422.2420(c) of title 42, Code of Federal Regulations (or a successor regulation)) of such plan.
“(ii) The amount and percentage of such revenue expended on incurred claims (as determined in accordance with paragraphs (2) through (4) of section 422.2420(b) of title 42, Code of Federal Regulations (or a successor regulation)).
“(iii) The amount and percentage of such revenue expended on non-claims costs (as defined in section 422.2401 of title 42, Code of Federal Regulations (or a successor regulation)).
“(iv) The amount of the difference between the MLR numerator (as determined in accordance with paragraph (b) of section 422.2420 of title 42, Code of Federal Regulations (or a successor regulation)) and the MLR denominator (as determined in accordance with paragraph (c) of such section (or a successor regulation)).
“(v) The amount described in clause (iv), expressed as a percentage of such revenue.
“(B) Manner of publication.—The Secretary may require information submitted and published by an MA organization under subparagraph (A), in addition to being so published and submitted at the MA plan level, to be so submitted and published in the aggregate in such manner as specified by the Secretary (such as across all MA plans offered by such organization).
“(C) Application of certain provisions.—In applying section 422.2420 of title 42, Code of Federal Regulations (or a successor regulation), for purposes determining any amount or percentage under subparagraph
(A), any reference to an ‘MA contract’, ‘MSA contract’, ‘contract’, or ‘contract year’ shall be treated as a reference to an ‘MA plan’, ‘MSA plan’, ‘plan’, or ‘plan year’, respectively.”.
(b) Ensuring Comparability of Benefit Information.—Section 1851(d)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395w- 21(d)(2)(A)(ii)) is amended by adding at the end the following new sentence: “With respect to any such information that is provided in an electronic format on or after the first day of the first plan year that begins at least 1 year after the date of the enactment of this sentence, such information shall, to the greatest extent practicable, be presented in the same uniform format applicable to information required to be made available by group health plans and health insurance issuers under section 2715 of the Public Health Service Act.”. <all>
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