Medicare Advantage Prompt Pay Act

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 5454 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 5454 To amend title XVIII of the Social Security Act to apply improved prompt payment requirements to Medicare Advantage organizations. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES September 18, 2025 Mr. Arrington (for himself and Ms. Sanchez) 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 apply improved prompt payment requirements to Medicare Advantage organizations. 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 Prompt Pay Act''. SEC. 2. APPLICATION OF IMPROVED PROMPT PAYMENT REQUIREMENTS TO MEDICARE ADVANTAGE ORGANIZATIONS. (a) Requirements.-- (1) In general.--Section 1857 of the Social Security Act (42 U.S.C. 1395w-27) is amended-- (A) in subsection (f), by striking paragraph (1) and inserting the following: ``(1) Requirements.-- ``(A) Items and services furnished by in-network and out-of-network providers of services and suppliers.-- ``(i) In general.--A contract under this part between the Secretary and a Medicare Advantage organization offering a Medicare Advantage plan shall require the organization to provide prompt payment for not less than 95 percent of clean claims submitted to the organization, with respect to covered items or services furnished to enrollees by a provider of services or supplier, within the applicable