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
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.
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.