Medicare gains a window into what Advantage plans really charge you

What it does

This bill requires Medicare Advantage plans to include four new data points in their encounter records starting January 2027: the allowed amount for each service, the patient's cost-sharing obligation, and indicators showing whether the patient received an in-home health risk assessment—separately flagging assessments from entities the plan owns versus independent entities. The goal is to give Medicare and researchers better visibility into what MA plans actually charge patients and which plans are steering patients toward affiliated assessment providers.

Why we flagged it

The bill's operative mechanism is a data-disclosure mandate designed to expose MA plan pricing and potential steering of patients toward affiliated assessment entities. It is a transparency and accountability measure, not a payment reform or benefit expansion.

What the text implies

• The bill requires plans to separately flag assessments from 'specified assessment entities' (those with ownership ties to the plan) versus independent entities. This creates a permanent audit trail of potential self-dealing, which may incentivize plans to reduce or disclose such relationships rather than hide them.
• Encounter data is used by CMS to set future MA payment rates and by researchers to study plan behavior. Mandatory disclosure of allowed amounts and cost-sharing may reveal wide variation in what different plans charge for identical services, potentially triggering pressure for rate standardization or competitive disclosure.
• The 'assessment entity' definition is delegated to the Secretary, creating regulatory flexibility but also potential for future narrowing or expansion of what counts as a 'specified' (affiliated) entity—a future administration could weaken the conflict-of-interest signal by redefining the term.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Ordinary Medicare beneficiaries gain transparency into what they are actually paying and whether their MA plan is steering them toward affiliated providers—information needed to make informed plan choices and to detect self-dealing. Regulators and researchers gain data to monitor MA plan pricing and conflicts of interest, supporting market accountability.

Named in the bill

Medicare Advantage plans, Centers for Medicare & Medicaid Services (CMS), Social Security Act § 1859, Assessment entities, MA organizations

Where it stands

1 cosponsor: 1 Republicans.

• Jun 23, 2026 — Introduced · Congress.gov: “Introduced in House”
• Jun 23, 2026 — 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…”
• Jun 25, 2026 — Markup held in committee · Congress.gov: “Subcommittee Consideration and Mark-up Session Held”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

3 lobbying clients named this bill on 3 disclosure filings across 1 quarter, Jun 2026 to Jun 2026. Those filings disclosed $906,347 in lobbying spend. A filing names 21 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 61% of bills with at least one filing.

Diana DeGette, the sponsor, reported $915,500 in PAC receipts in the 2026 cycle.

• Blood Cancer United (fka the Leukemia & Lymphoma Society) — $590,000 on 1 filing
• Blue Cross Blue Shield of Michigan — $276,347 on 1 filing
• Horizon Blue Cross Blue Shield of New Jersey — $40,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.