Prompt and Fair Pay Act

Key Provisions

• Requires Medicare Advantage plans to pay doctors and hospitals at least the same rates as original Medicare, starting January 1, 2027.
• Sets deadlines for Medicare Advantage plans to pay in-network doctors and hospitals. These are 14 days for electronic claims and 30 days for paper claims, starting January 1, 2027.
• Defines a "clean claim" and requires plans to notify providers quickly if a claim has errors.
• Requires Medicare Advantage plans to pay interest to doctors and hospitals for claims paid late.
• Lets the Secretary of Health and Human Services end or refuse to renew contracts with Medicare Advantage plans. This applies to plans that do not follow the new prompt payment rules.