Prompt and Fair Pay Act

The Prompt and Fair Pay Act would, starting with plan years beginning January 1, 2027, require Medicare Advantage (MA) contracts to pay providers and suppliers at parity with what the original Medicare fee-for-service (FFS) program would pay for the same items and services, including any cost-based payment methods under FFS. In addition, the bill would establish enforceable prompt payment requirements for MA plans to pay in-network providers within specific timeframes after a clean claim is received, and create procedures for identifying, notifying about, and correcting defective claims. It also authorizes the Secretary to enforce these prompt payment rules. The overarching goals are to ensure MA plans reimburse at least as much as traditional Medicare would for the same care and to improve payment speed and transparency for providers, which could help patients maintain access to timely care.