To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6111 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 6111

    To amend title XVIII of the Social Security Act to require any 
   advertisement of a Medicare Advantage plan to include information 
  related to the rates of prior authorization denials under such plan.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 18, 2025

    Mr. Pocan (for himself, Mr. Carson, Mr. Cohen, Ms. DeLauro, Mr. 
 Doggett, Ms. Jayapal, Mr. Khanna, Ms. Norton, Ms. Ocasio-Cortez, Ms. 
 Schakowsky, Mr. Takano, Mr. Thanedar, Ms. Tlaib, Ms. McBride, and Ms. 
    Omar) 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 require any 
   advertisement of a Medicare Advantage plan to include information 
  related to the rates of prior authorization denials under such plan.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. REQUIRING MA PLAN ADVERTISEMENTS TO INCLUDE INFORMATION ON 
              PRIOR AUTHORIZATION.

    Section 1852(c) of the Social Security Act (42 U.S.C. 1395w-22(c)) 
is amended by adding at the end the following new paragraph:
            ``(3) Advertisement requirements.--Beginning on the date 
        that is 1 year after the date of the enactment of this 
        paragraph, any advertisement of an MA plan shall include, with 
        respect to the most recent plan year ending before such 
        advertisement is disseminated, a verbal and visual disclosure 
        (to the extent possible) of--
                    ``(A) the number of requests for prior 
                authorization that were denied under such plan during 
                such plan year, including requests for prior 
                authorization that were reconsidered and approved after 
                being denied;
                    ``(B) the number of requests for prior 
                authorization described in subparagraph (A) that were 
                reconsidered and approved after being denied; and
                    ``(C) with respect to the requests for prior 
                authorization described in subparagraph (B), the 
                average number of days between the date on which such a 
                request was initially denied and the date on which such 
                request was approved.''.
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