Medicare Advantage Prompt Pay Act

HR 5454, the Medicare Advantage Prompt Pay Act, requires Medicare Advantage plans to pay 95% of valid claims (with complete data) within 14 days for electronic claims or 30 days for paper claims, starting January 1, 2027. Plans that miss these deadlines must pay interest at standard government rates and face $25,000 civil penalties per violation. The bill also mandates annual reports showing payment rates for in-network versus out-of-network claims and interest paid. This directly affects Medicare Advantage insurers and healthcare providers (like doctors and hospitals) who bill these plans.