Prompt and Fair Pay Act

HR 4559, the Prompt and Fair Pay Act, requires Medicare Advantage (MA) plans to pay healthcare providers the same amount as original Medicare (fee-for-service) for covered services starting in 2027, directly affecting MA plans and providers who treat Medicare patients. It mandates that MA plans pay "clean claims" (claims with no missing information) within 14 days for electronic submissions or 30 days for paper claims, with interest penalties for late payments based on Treasury rates. The bill also requires MA plans to clearly explain claim denials and provide timely notifications about missing information, improving transparency and reducing payment delays. These changes aim to standardize payments between MA plans and traditional Medicare while ensuring providers receive timely compensation.