Transparency in Medicare Advantage Steering Act
- Bill Number
- H.R. 9395
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-06-25: Forwarded by Subcommittee to Full Committee by Voice Vote.
- Last Updated
- 2026-07-06T16:34:18Z
AI-Generated Summary
Summary of H.R. 9395: Transparency in Medicare Advantage Steering Act
Purpose
This legislation aims to increase transparency regarding the role of agents, brokers, and third parties in enrolling individuals in Medicare Advantage (MA) plans by requiring MA organizations to report details on enrollment methods and related compensation.
Key Provisions
- Reporting Requirements: Beginning in 2028, MA organizations must annually report to the Secretary of Health and Human Services:
- For each enrollee, whether enrollment occurred through an agent, broker, or other third party, and if so, the amount and form of any compensation paid.
- The total compensation paid to all such agents, brokers, and third parties for enrolling individuals across all MA plans offered by the organization.
- Any additional information on these parties as required by the Secretary.
- Data Integration and Public Access: Starting in 2030, the Secretary must:
- Add an indicator in the Chronic Condition Data Warehouse (maintained by the Centers for Medicare & Medicaid Services) to flag enrollments made by agents, brokers, or third parties.
- Publish on the CMS website the total compensation amounts and other reported information from MA organizations.
Significant Changes to Existing Law
- This bill amends Section 1857(e) of the Social Security Act (42 U.S.C. 1395w-27(e)) by adding a new paragraph (7), which imposes these reporting obligations as a condition of MA organization contracts.
- It introduces mandatory data collection and public disclosure elements not previously required under existing MA program rules.
Potential Impacts
- Government Agencies: Increases administrative responsibilities for the Centers for Medicare & Medicaid Services in collecting, storing, and publicly sharing data, including updates to existing data systems.
- Citizens: Provides Medicare beneficiaries and the public with greater visibility into enrollment practices, which could inform choices about MA plans.
- International Relations: No direct effects anticipated.
Main Stakeholders Affected
- Medicare Advantage organizations, which must comply with new reporting duties.
- Agents, brokers, and third parties involved in MA enrollments, whose compensation details may become public.
- The Centers for Medicare & Medicaid Services, responsible for implementation and data management.
- Medicare beneficiaries, who may benefit from enhanced transparency in plan marketing.
Notable Legal, Constitutional, or Political Implications
- The changes focus on contractual requirements for MA organizations and data transparency measures within the existing Medicare framework, without apparent conflicts with constitutional principles.
- Politically, the bill promotes oversight of private-sector involvement in federal health programs, potentially influencing marketing practices in the MA market.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Ocasio-Cortez, Alexandria [D-NY-14]
Recent Actions
- 2026-06-25: Forwarded by Subcommittee to Full Committee by Voice Vote.
- 2026-06-25: Subcommittee Consideration and Mark-up Session Held
- 2026-06-23: 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.
- 2026-06-23: 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.
- 2026-06-23: Referred to the Subcommittee on Health.
- 2026-06-23: Introduced in House
- 2026-06-23: Introduced in House
Bill Versions
- Transparency in Medicare Advantage Steering Act — issued 2026-06-23 — PDF (4 pages)