Medicare Advantage plans must now automatically review denied claims
H.R. 6110 — To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. · Filed by Mark Pocan (D-WI) · 17 cosponsors · Introduced Nov 18, 2025 · Referred to committee
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What it does
This bill requires Medicare Advantage plans to automatically reconsider coverage denials without waiting for patients to request it. Currently, plans only reconsider denials when a patient asks; this bill makes reconsideration automatic and immediate, giving patients a second look at denied claims as a matter of course rather than requiring them to navigate the appeals process themselves.
Why we flagged it
The bill's sole operative effect is to shift Medicare Advantage reconsideration from opt-in (patient-initiated) to automatic (plan-initiated), a procedural protection that reduces barriers to coverage review for beneficiaries.
What the text implies
- Automatic reconsideration may increase administrative costs for Medicare Advantage plans, potentially affecting plan profitability and premium pricing in future years.
- The bill does not specify a timeline for automatic reconsideration, leaving implementation details to CMS regulation — the actual speed of review depends on future rulemaking.
- Plans may respond by tightening initial coverage criteria to reduce the volume of denials requiring automatic reconsideration, shifting the burden upstream rather than eliminating it.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Patients with denied Medicare Advantage claims receive automatic reconsideration without having to navigate appeals procedures themselves, reducing barriers to coverage and improving access to care. The burden of initiating review shifts from individual patients to plans, lowering friction and ensuring no denial goes unreviewed.
Named in the bill
Medicare Advantage plans, Centers for Medicare & Medicaid Services (CMS), Social Security Act Title XVIII, Medicare beneficiaries
Where it stands
17 cosponsors: 17 Democrats.
- Nov 18, 2025 — Introduced · Congress.gov: “Introduced in House”
- Nov 18, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
2 lobbying clients named this bill on 2 disclosure filings across 1 quarter, Dec 2025 to Dec 2025. Those filings disclosed $40,000 in lobbying spend. A filing names 18 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 41% of bills with at least one filing.
Mark Pocan, the sponsor, reported $474,320 in PAC receipts in the 2026 cycle.
- Center for Health and Democracy — $20,000 on 1 filing
- Social Security Works — $20,000 on 1 filing
Lobbying Disclosure Act filings through Jan 16, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (432 characters) on Jun 3, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Dec 2025. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jan 16, 2026 · page rendered 2026-10-20.
“Medicare Advantage plans must now automatically review denied claims” QuorumCivic. https://share.quorumcivic.app/bill/119/hr6110 Report an error
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