Medicare Advantage ads would have to tell people how often the plan first denies care that needs approval. They would also have to show how many denials later become approvals, and how long that takes.
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To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. 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. 6111: 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 who compare Medicare Advantage plans and the insurers that sell those plans. People shopping for coverage would see more information in ads about how often a plan first denies care that needs approval. Medicare Advantage insurers would have to add these numbers to ads and make sure the spoken and written disclosures fit the ad format.
Why this matters: Prior authorization can affect whether people get care on time, and this bill would put denial data directly in plan ads. People comparing Medicare Advantage plans could see how often a plan first says no and how long some later approvals take. The bill could make shopping for coverage clearer, but it does not say how people will use the numbers or whether plans will change their behavior.
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