Medicare Advantage plans must pay doctors faster—or face fines

What it does

This bill requires Medicare Advantage insurance plans to pay healthcare provider claims faster and more reliably. Specifically, it mandates that plans pay at least 95% of valid claims within 14 days (if submitted electronically) or 30 days (if submitted by mail), and imposes interest penalties and fines up to $25,000 per violation if they fail to meet these deadlines. The bill also requires plans to publicly report their payment performance data.

Why we flagged it

The bill's core function is to impose payment speed and accuracy standards on Medicare Advantage plans, with enforcement mechanisms (interest, fines) and transparency requirements. It is regulatory accountability legislation, not a subsidy or carve-out.

What the text implies

• Faster payment cycles may increase short-term cash flow pressure on Medicare Advantage insurers, potentially affecting their ability to invest reserves or manage seasonal claim volatility.
• The 95% threshold for on-time payment means 5% of claims can still be delayed without penalty, creating a potential loophole for systematic slow-payment of edge-case claims.
• Interest penalties are calculated using federal prompt-payment rates (currently ~8% annually), which may be insufficient to fully compensate providers for working-capital costs and administrative burden.
• Public reporting of payment metrics may create competitive pressure among MA plans but could also enable gaming (e.g., plans rejecting claims as 'incomplete' to avoid the 95% denominator).
• The January 1, 2027 effective date gives MA plans 16+ months to reprogram claims systems, but smaller regional plans may face disproportionate compliance costs.

Who it affects

Ordinary citizens benefit through faster provider reimbursement, which reduces provider financial strain, supports healthcare access, and creates accountability for insurance plans. Faster payment cycles reduce administrative burden on medical practices, which can lower costs and improve service. The transparency requirement allows patients and regulators to monitor plan compliance.

Who stands to gain

• healthcare providers and medical practices (faster cash flow)
• small and independent physician groups (reduced working-capital strain)
• hospital systems (improved revenue cycle management)

Named in the bill

Medicare Advantage organizations, Centers for Medicare & Medicaid Services (CMS), healthcare providers, medical suppliers, National Uniform Billing Committee, Section 1857 Social Security Act, Section 1851 Social Security Act, UB-04 form, CMS 1500 form, Bristol Myers Squibb (BMY), Guardant Health (GH), Pfizer (PFE) — and 2 more

Where it stands

2 cosponsors: 1 Democrats, 1 Republicans.

• Sep 18, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Sep 18, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”

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

Money around this bill

10 lobbying clients named this bill on 16 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $8,816,393 in lobbying spend. A filing names 10 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 91% of bills with at least one filing.

Catherine Cortez Masto, the sponsor, reported $298,634 in PAC receipts in the 2026 cycle.

• American Hospital Association — $4,470,000 on 1 filing
• America's Essential Hospitals — $1,080,000 on 2 filings
• Federation of American Hospitals — $710,000 on 1 filing
• Providence St. Joseph Health — $680,000 on 4 filings
• Greater New York Hospital Association — $580,000 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.