[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5243 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 5243

   To amend title XVIII of the Social Security Act to increase data 
    transparency for supplemental benefits under Medicare Advantage.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 10, 2025

Ms. McClellan 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

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to increase data 
    transparency for supplemental benefits under Medicare Advantage.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. INCREASING DATA TRANSPARENCY FOR SUPPLEMENTAL BENEFITS UNDER 
              MEDICARE ADVANTAGE.

    (a) In General.--Section 1857(e) of the Social Security Act (42 
U.S.C. 1395w-27(e)) is amended by adding at the end the following new 
paragraph:
            ``(6) Reporting of enrollee-level data on supplemental 
        benefits.--
                    ``(A) In general.--Beginning with plan years 
                beginning on or after January 1, 2029, a contract under 
                this section with an MA organization shall require the 
                organization to submit to the Secretary, for each MA 
                plan offered by the organization, enrollee-level data 
                on supplemental benefits (by item or service, or 
                category of item or service, as determined appropriate 
                by the Secretary, and national provider identifier), 
                including eligibility for such benefits, the types of 
                benefit categories offered, data on utilization of and 
                payments for such benefits (including the total amount 
                spent by the plan for each enrollee who utilized such 
                benefits and the total out-of-pocket cost per 
                utilization for each enrollee).
                    ``(B) Data access.--
                            ``(i) In general.--On the first Monday in 
                        October of each year (beginning with 2030), the 
                        Secretary shall make data submitted under 
                        subparagraph (A) available to individuals and 
                        entities for the purpose of conducting--
                                    ``(I) evaluations and other 
                                analysis to support the program under 
                                this title; and
                                    ``(II) other health care related 
                                research.
                            ``(ii) Public use data file.--Not later 
                        than October 1 of each year (beginning with 
                        2030), the Secretary shall make a public use 
                        data file containing the data submitted under 
                        subparagraph (A) available on the internet 
                        website of the Centers for Medicare & Medicaid 
                        Services.
                            ``(iii) Confidentiality.--In making data 
                        available under this subparagraph, the 
                        Secretary shall have in place procedures to 
                        safeguard the privacy of any individually 
                        identifiable enrollee information.''.
    (b) Rule of Construction.--Nothing in the amendments made by this 
section shall affect the collection of information as proposed pursuant 
to the notice entitled ``Agency Information Collection Activities: 
Proposed Collection; Comment Request'', published in the Federal 
Register on March 14, 2023 (88 Fed. Reg. 15726).
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