HR 3467 United States House · 119th Congress

To amend title XVIII to reform the Medicare Advantage program.

HR 3467 reforms Medicare Advantage (MA) by requiring most plans to use fixed payments per member (capitated payments) starting in 2028, with exceptions for existing plans and special needs plans. It modifies payments by reducing blended benchmarks, changing how health status risk adjustments are calculated (using only face-to-face/telehealth diagnoses), and eliminating quality-based payment increases. The bill mandates automatic enrollment into the lowest-premium MA plan for eligible beneficiaries starting in 2028, with a 3-year enrollment lock-in period unless a hardship event occurs. Additionally, it requires MA plans to include hospice care coverage (with a 2028 transition exception) and adds an exception for durable medical equipment and Part D drugs under the Stark Law.
Bill status in committee 1 of 4 stages cleared
Introduction
May 2025
Committee Review
Floor Vote
President
Introduced May 15, 2025 Last action Jun 3, 2025
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Committee
1
May 15, 2025
Committee
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.
lower
May 15, 2025
Introduced
Introduced in House
lower
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
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P
Photo of David Schweikert
David Schweikert
RRepublican
AZ
1