Back to all bills
HR 6110119th CongressIn Committee
To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage.
Introduced: Nov 18, 2025
Sponsor: Rep. Pocan, Mark [D-WI-2] (D-Wisconsin)
Standard Summary
Comprehensive overview in 1-2 paragraphs
A bill amending Title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider any denial of coverage, with enforcement provisions for non‑compliance.
Key Points
- 1Automatic reconsideration of prior‑authorization denials
- 2Definition of prior‑authorization coverage determination
- 3Enforcement mechanism: contract termination for non‑compliance
- 4Clarification of the reconsideration process
- 5Protection of enrollees’ access to care
Impact Areas
Medicare Advantage plansEnrollees and beneficiariesHealthcare providers and insurersMedicare program administrationDepartment of Health and Human Services
Generated by openai/gpt-oss-20b:free on Nov 19, 2025