Medicare Advantage Prompt Pay Act

The Medicare Advantage Prompt Pay Act would require Medicare Advantage organizations (MAOs) to speed up and standardize how they pay providers for items and services furnished to MA enrollees. By amending the Social Security Act, the bill sets a target that MAOs must pay at least 95% of clean claims within short timelines (14 days for electronically submitted claims; 30 days for other claims). It creates defined terms for what counts as a clean claim, provides a presumption about when a claim is considered received, and requires MAOs to pay interest if timely payment is not made. The bill also adds civil penalties for prompt payment violations and requires MAOs to report detailed compliance data to CMS. The new requirements would take effect for items/services provided on or after January 1, 2027 (and for MA contract years beginning on or after that date).