H.R.5454

Medicare Advantage Prompt Pay Act

Introduced·9/18/25

Medicare Advantage Prompt Pay Act aims to enforce stricter prompt payment rules for Medicare Advantage organizations.

The Medicare Advantage Prompt Pay Act amends title XVIII of the Social Security Act to enhance prompt payment requirements for Medicare Advantage organizations. It establishes a rebuttable presumption for the date a claim is received by an organization, with different timelines for electronic and non-electronic claims. The bill mandates that organizations must pay at least 95% of clean claims within 14 days for electronic claims and 30 days for non-electronic claims. Clean claims are defined as those with complete data sets and proper formatting.

Included in complete analysis

  • Overview
  • Core Provisions
  • Implementation
  • Impact
  • Legal Framework
  • Critical Issues

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Where it stands

Current
Ways And Means Committee
Next
Committee decision

Sponsors

Democratic CaucusRepublican Caucus

History

Sep 18, 2025

House

Introduced in House

Sep 18, 2025

House

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.