Medicare Advantage Prompt Pay Act

Key Provisions

• Requires Medicare Advantage plans to pay at least 95% of complete claims within 14 days for electronic claims from in-network providers.
• Requires Medicare Advantage plans to pay at least 95% of other complete claims (like paper claims or those from out-of-network providers) within 30 days.
• Requires Medicare Advantage plans to pay interest to healthcare providers for any complete claims paid after the deadline.
• Lets the government fine Medicare Advantage plans up to $25,000 for each time they fail to meet these payment deadlines.
• Requires Medicare Advantage plans to report data on how well they follow these prompt payment rules, including how many claims are paid on time and the total interest paid for late payments.