S. 5034

119 S5034 IS: Medicare Advantage Supplemental Benefits Transparency Act of 2026
 U.S. Senate
 2026-07-20
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 EN
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 II  119th CONGRESS  2d Session  S. 5034  IN THE SENATE OF THE UNITED STATES   July 20, 2026   Mr. Warner  (for himself and  Mrs. Blackburn ) introduced the following bill; which was read twice and referred to the  Committee on Finance    A BILL
To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
1.
Short title
This Act may be cited as the   Medicare Advantage Supplemental Benefits Transparency Act of 2026  .
2.
Increasing data transparency for supplemental benefits under Medicare Advantage
(a)
In general
Section 1857(e) of the Social Security Act ( 42 U.S.C. 1395w–27(e) ) is amended by adding at the end the following new paragraph:
(7)
Reporting of enrollee-level data on supplemental benefits
(A)
In general
Beginning with plan years beginning on or after January 1, 2029, a contract under this section with an MA organization shall require the organization to submit to the Secretary, for each MA plan offered by the organization, enrollee-level data on supplemental benefits (by item or service, or category of item or service, as determined appropriate by the Secretary, and National Provider Identifier (if applicable)), including eligibility requirements for such benefits, the benefit category applicable with respect to each such benefit, and data on utilization of and payments for such benefits (including the total amount spent by the plan for each enrollee who utilized such benefits and the total out-of-pocket cost per utilization for each enrollee).
(B)
Data access
(i)
In general
Not later than January 1 of the year that is two years after the beginning of a plan year for which data is submitted under subparagraph (A), the Secretary shall—
(I)
upon request, make such data available to individuals and entities for the purpose of conducting—
(aa)
evaluations and other analyses to support the program under this title; and
(bb)
other health care related research; and
(II)
make available on the internet website of the Centers for Medicare & Medicaid Services a public-use data file containing such data in de-identified form.
(ii)
Confidentiality
In making data available under clause (i)(I), the Secretary shall have in place procedures to safeguard the privacy and security of any individually identifiable enrollee information.
 .
(b)
Rule of construction
Nothing in the amendments made by this section shall affect the collection of information as proposed, or so finalized, pursuant to—
(1)
the notice entitled  Agency Information Collection Activities: Proposed Collection; Comment Request , published in the Federal Register on March 14, 2023 (88 Fed. Reg. 15726); or
(2)
the notice entitled  Agency Information Collection Activities: Submission for OMB Review; Comment Request , published in the Federal Register on September 25, 2023 (88 Fed. Reg. 65689).
(c)
Implementation funding
For the purposes of carrying out the amendment made by this section, there are appropriated, out of amounts in the Treasury not otherwise appropriated, to the Secretary of Health and Human Services, $12,000,000 for fiscal year 2026, to remain available until expended.