Sponsors
The bill increases transparency and oversight of Medicare Advantage supplemental benefits (helping beneficiaries, researchers, and regulators) but does so at the cost of added administrative burden—especially for smaller plans/providers—and a nontrivial risk to beneficiary privacy.
Medicare beneficiaries: require enrollee-level reporting of supplemental benefits and out-of-pocket costs so beneficiaries can better understand benefit use and their financial burden.
CMS and program administrators (and hospitals/health systems): enable improved oversight of Medicare Advantage supplemental benefit spending and the potential identification of disparities or fraud through NPI-linked utilization and payment data.
Researchers and policymakers: create annual, standardized public-use data (beginning 2030) to support program evaluation and health services research.
Medicare Advantage plans and smaller providers/plans: impose additional administrative and compliance costs to collect, map (including NPIs), and submit enrollee-level data beginning 2029, with disproportionate burdens on small plans and providers.
Taxpayers and Medicare beneficiaries: risk of privacy breaches or re-identification if de-identification procedures and safeguards prove insufficient, exposing sensitive health information.
Based on analysis of 2 sections of legislative text.
Requires MA plans to submit enrollee-level supplemental benefit data starting in 2029 and directs HHS to publish annual public-use data files beginning 2030 with privacy safeguards.
Introduced September 10, 2025 by Jennifer McClellan · Last progress September 10, 2025
Requires Medicare Advantage (MA) plans to submit enrollee-level data on supplemental benefits for plan years beginning January 1, 2029, including eligibility, benefit types, utilization, payments, enrollee out-of-pocket costs per use, and provider identifiers. Directs the Secretary of HHS to publish an annual public-use data file by October each year starting in 2030, while implementing safeguards to protect individually identifiable information.