SB 2879, the “Medicare Advantage Prompt Pay Act,” would amend the Social Security Act to impose new prompt-payment rules on Medicare Advantage organizations. The bill requires MA plans to pay at least 95 percent of clean claims for covered items and services within specified deadlines: 14 days for electronically submitted claims and 30 days for paper or other non-electronic claims. It also creates a rebuttable presumption about when a claim is received, defines what counts as a clean claim, and requires interest to be paid on late clean claims at the federal prompt-payment interest rate.
The bill further authorizes civil money penalties of up to $25,000 for each determination that an MA organization failed to comply with the prompt-payment requirement. In addition, it amends beneficiary information requirements so Medicare Advantage plans must disclose data on prompt-payment compliance, including the number and percentage of claims paid on time, claims paid with interest, and the total interest paid. The amendments would apply to items and services furnished on or after January 1, 2027, and to contract years beginning on or after that date.
Impact
The bill would directly amend sections 1857 and 1851 of the Social Security Act, adding federal payment-timing standards and reporting obligations for Medicare Advantage plans. It would affect Medicare Advantage organizations, providers of services, and suppliers by establishing enforceable deadlines for claim payment, interest penalties for late payment, and potential civil money penalties for noncompliance. It would also expand the information available to beneficiaries and regulators about plan payment performance.
Sentiment
Available context shows the bill was introduced by Senators Cortez Masto and Blackburn and then referred to the Senate Finance Committee, with no recorded votes or committee transcript excerpts provided. Based on the bipartisan sponsorship and the bill’s consumer/provider payment focus, the measure appears aimed at improving administrative fairness and transparency in Medicare Advantage claims processing. There is no direct evidence in the provided materials of organized support or opposition, but the proposal is structured as a regulatory enforcement measure rather than a broad program redesign.
Contention
The main policy tension is between stronger payment protections for providers and suppliers and the administrative burden on Medicare Advantage organizations. Supporters are likely to favor faster payment, interest on late claims, and public reporting as tools to reduce delays and improve accountability. Potential concerns for MA plans may include compliance costs, the operational challenge of meeting strict deadlines, and exposure to civil money penalties, especially for high-volume claims processing. The bill also distinguishes between in-network and out-of-network claims for prompt-payment purposes, which could be a point of debate in implementation.
To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program.