Medicare Advantage plans would have to review every denied coverage decision on their own. Patients would not need to file a request first. The review deadline would start on the day the plan denies coverage.
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To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. is a House bill in committee. The latest recorded action: 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.
Latest action on H.R. 6110: 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.
Who this affects: This bill mainly affects people enrolled in Medicare Advantage plans, especially those who may not know how to appeal a denial or may have trouble filing a request. It also affects Medicare Advantage plans, because they would have to review every denial instead of waiting for some patients to ask.
Why this matters: A denied claim or service can leave a patient without care unless someone pushes back. This bill would make the plan take the first review step automatically. That could help people who miss appeal rules or do not understand them. It could also add work for plans, and the bill does not say how that would affect costs, speed, or approval rates.
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