Medicare Advantage Improvement Act of 2026

The Medicare Advantage Improvement Act of 2026 aims to speed up care decisions and increase transparency for Medicare Advantage enrollees and providers. Starting in 2028, the bill requires insurance plans to respond to most prior authorization requests within 72 hours and to provide real-time decisions for low-risk services, while also banning requirements for re-authorization when a treatment plan is clinically modified. The legislation introduces a new compliance scoring system that will publicly rank plans and reduce payments to those with poor performance, alongside stricter rules ensuring medical necessity standards match those of traditional Medicare.