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HR 6031119th CongressIn Committee

Medicare Advantage Integrity Act of 2025

Introduced: Nov 12, 2025
Sponsor: Rescom. Hernández, Pablo [D-PR-At Large] (D-Puerto Rico)
Standard Summary
Comprehensive overview in 1-2 paragraphs

Establishes minimum benchmark rates for Medicare Advantage plans in areas with low fee-for-service penetration.

Key Points

  • 1Creates 0.70 floor for geographic adjustment factors in Medicare Advantage
  • 2Applies to 2026 and subsequent years
  • 3Requires 50% of increased benchmark amounts to go to basic benefits
  • 4Addresses payment disparities in low-penetration regions
  • 5Amends Social Security Act sections 1853 and 1854

Impact Areas

Medicare Advantage plansHealthcare providersMedicare beneficiariesRural and underserved areas
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