Adjusts how Medicare sets payment benchmarks for Medicare Advantage plans in areas where the local hospital wage index jumped more than 20% in a single year. Starting in 2026, the Health and Human Services Secretary would add a local growth percentage on top of the national per-capita growth rate used to set MA payments in those affected areas, weighted by how much of local Medicare spending goes to wage-adjusted hospital payments. The adjustment must be "benchmark neutral" across all MA areas, meaning increases in affected areas are offset elsewhere. CMS would also publish hospital-level Medicare payment data for each MA payment area to support transparency.
Transparency & Accountability
- CMS hospital payment data — Required to be published per MA payment area
Congressional Summary
Protecting Options for Seniors Act of 2025This bill increases payments for Medicare Advantage plans in areas in which the average hospital wage index increased by more than 20% compared to the previous year. Payment increases are based on the percentage by which the average hospital wage index increased compared to the previous year and weighted by the proportion of attributable payments in the area.
Details
- Congress
- 119th
- Chamber
- House
- Status
- summarized
- Action
- Introduced in House
- Action Date
- 2025-04-02
- Date Added
- 2026-05-22
- Source
- Congress.gov →
Like reading a bill in plain English?
We're building an app that does this for every bill in Congress and lets you tell your reps how you want them to vote. We're a small team getting ready to launch, and we're trying to show investors that real people want this. Be one of them. Help us get it built. Leave your email and we'll tell you the moment the app is ready.