Congressional Doctors Introduce Medicare Advantage Improvement Act

WASHINGTON—Rep. Mariannette Miller-Meeks joined fellow physician members of Congress in introducing the bipartisan Medicare Advantage Improvement Act of 2026 (HR 8375), saying the legislation is aimed at restoring accountability, strengthening patient protections and ensuring seniors receive timely, reliable care.

According to Miller-Meeks, the bill “takes on growing concerns within Medicare Advantage (MA) by increasing transparency, cracking down on abusive practices and aligning coverage standards with traditional Medicare to better serve America’s seniors.”

“For too long, cases of abuse have crept into Medicare Advantage, pulling it away from its core mission of serving America’s seniors,” said Miller-Meeks. “As a physician, I’ve seen how these practices delay care, create unnecessary barriers and increase the cost of health care. This bill restores accountability, cracks down on bad actors, and ensures Iowa seniors can access the care they need, without delay, without denial and without interference from bureaucratic red tape.”

“Medicare is a promise to America’s seniors that they will have dependable access to quality health care in their later years,” said Rep. John Joyce. “However, that promise has been undermined by unnecessary barriers to care—particularly through excessive use of prior authorization and inappropriate coverage denials in Medicare Advantage. As a physician, I have seen firsthand how these delays harm patients and take valuable time away from the doctor-patient relationship. The Medicare Advantage Improvement Act will restore accountability, reduce unnecessary barriers and ensure that seniors receive timely, high-quality care.”

Background

Medicare Advantage has grown rapidly in recent years, now serving millions of seniors across the country. While the program was designed to provide high-quality, coordinated care, increasing concerns have emerged over prior authorization delays, inconsistent coverage decisions and administrative barriers that can interfere with timely treatment.

The Medicare Advantage Improvement Act of 2026 directly addresses these challenges by implementing reforms aimed at protecting patients and improving program integrity. The legislation would:

• Strengthen oversight and accountability for Medicare Advantage plans that fail to meet compliance standards
• Increase transparency and streamline prior authorization processes to reduce delays in care
• Align coverage criteria with traditional Medicare to ensure consistency for patients and providers
• Reduce administrative burdens through real-time, automated systems that improve efficiency
• Expand access to post-acute care providers, ensuring seniors can receive the care they need without unnecessary barriers

Industry Reactions

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), an organization representing long term and post-acute care providers, praised lawmakers for the introduction of the Medicare Advantage Improvement Act of 2026. 

“The Medicare Advantage Improvement Act of 2026 represents a significant step towards ensuring Medicare Advantage delivers on its promise to America’s seniors,” said Clif Porter, president and CEO of AHCA/NCAL. “We commend these lawmakers for developing a better way to enable seniors to have timely access to care and hold plans accountable. We urge continued bipartisan support and swift passage through Congress.” 

More seniors are enrolling in Medicare Advantage plans than traditional Medicare because it offers many perks appealing to seniors; however, large, insurer-led MA plans can deny or delay beneficiaries’ access to necessary skilled nursing and post-acute care. From 2019 to 2022, the top MA insurers denied prior authorization requests for post-acute care more frequently than for other services. This has contributed to a doubling of seniors leaving MA for traditional Medicare in their final year of life—shifting costs onto taxpayers.

“This bill addresses many of the obstacles driven by insurer-led Medicare Advantage plans that were making it unnecessarily difficult for seniors and their families to navigate care options and receive coverage for medically necessary care,” said Nisha Hammel, vice president of reimbursement policy and population health at AHCA/NCAL. “Coverage decisions for Medicare Advantage beneficiaries must be driven by each patient’s needs and clinical necessity, with appropriate oversight that ensures compliance and patient protections.”

Co-leading this bill alongside Miller-Meeks are Reps. John Joyce, Greg Murphy, Jimmy Panetta, Ami Bera, Beth Van Duyne and Kim Schrier.

To read the bill click here.