[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9644 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 9644

To amend title XVIII of the Social Security Act to promote transparency 
                of Medicare Advantage plan information.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 13, 2026

  Mr. Moran 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 promote transparency 
                of Medicare Advantage plan information.

    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 MLR Transparency 
Act''.

SEC. 2. PROMOTING TRANSPARENCY OF MEDICARE ADVANTAGE PLAN INFORMATION.

    (a) Overhead Costs and Claim Payment Information.--Section 1857(e) 
of the Social Security Act (42 U.S.C. 1395w-27(e)) is amended by adding 
at the end the following new paragraph:
            ``(7) Overhead costs and claim payment information.--
                    ``(A) In general.--Beginning with plan years 
                beginning on or after January 1, 2029, a contract under 
                this section with an MA organization shall require the 
                organization, with respect to each MA plan offered by 
                such organization during such plan year, to submit to 
                the Secretary and publish on the public website of such 
                organization the following information in a consumer-
                friendly format specified by the Secretary:
                            ``(i) The amount of total revenue (as 
                        determined in accordance with section 
                        422.2420(c) of title 42, Code of Federal 
                        Regulations (or a successor regulation)) of 
                        such plan.
                            ``(ii) The amount and percentage of such 
                        revenue expended on incurred claims (as 
                        determined in accordance with paragraphs (2) 
                        through (4) of section 422.2420(b) of title 42, 
                        Code of Federal Regulations (or a successor 
                        regulation)).
                            ``(iii) The amount and percentage of such 
                        revenue expended on non-claims costs (as 
                        defined in section 422.2401 of title 42, Code 
                        of Federal Regulations (or a successor 
                        regulation)).
                            ``(iv) The amount of the difference between 
                        the MLR numerator (as determined in accordance 
                        with paragraph (b) of section 422.2420 of title 
                        42, Code of Federal Regulations (or a successor 
                        regulation)) and the MLR denominator (as 
                        determined in accordance with paragraph (c) of 
                        such section (or a successor regulation)).
                            ``(v) The amount described in clause (iv), 
                        expressed as a percentage of such revenue.
                    ``(B) Manner of publication.--The Secretary may 
                require information submitted and published by an MA 
                organization under subparagraph (A), in addition to 
                being so published and submitted at the MA plan level, 
                to be so submitted and published in the aggregate in 
                such manner as specified by the Secretary (such as 
                across all MA plans offered by such organization).
                    ``(C) Application of certain provisions.--In 
                applying section 422.2420 of title 42, Code of Federal 
                Regulations (or a successor regulation), for purposes 
                determining any amount or percentage under subparagraph 
                (A), any reference to an `MA contract', `MSA contract', 
                `contract', or `contract year' shall be treated as a 
                reference to an `MA plan', `MSA plan', `plan', or `plan 
                year', respectively.''.
    (b) Ensuring Comparability of Benefit Information.--Section 
1851(d)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395w-
21(d)(2)(A)(ii)) is amended by adding at the end the following new 
sentence: ``With respect to any such information that is provided in an 
electronic format on or after the first day of the first plan year that 
begins at least 1 year after the date of the enactment of this 
sentence, such information shall, to the greatest extent practicable, 
be presented in the same uniform format applicable to information 
required to be made available by group health plans and health 
insurance issuers under section 2715 of the Public Health Service 
Act.''.
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