To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans.

HR 6109 amends Medicare Advantage plan rules to address excessive initial denials of prior authorizations. It requires the Medicare program to terminate contracts with plans that reverse more than 25% of initially denied coverage requests through appeal or reconsideration during a plan year. The bill specifically targets plans where a high rate of reversed denials indicates improper initial denials, or where plans fail to properly reconsider denials compared to prior years. This directly affects Medicare Advantage plan providers, imposing new accountability for their prior authorization practices.