To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
The source supplies the latest action, but no lifecycle stage.
Latest action (25 Jun 2026): Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote.
What this bill does
H.R. 5243 would amend the Social Security Act to require Medicare Advantage (MA) organizations to submit detailed, enrollee-level data on the supplemental benefits offered under their plans. Beginning with plan years starting on or after January 1, 2029, MA organizations would have to report data by item, service, or benefit category, and by provider identifier, including who is eligible for benefits, what types are offered, and utilization and payment information, such as total plan spending and out-of-pocket costs per enrollee. Starting in 2030, the Secretary of Health and Human Services would make this data available annually—both to researchers and analysts for program evaluation and health care research, and to the public through a data file posted online, with safeguards to protect individually identifiable information.
The bill primarily affects Medicare Advantage organizations, which would face new federal reporting requirements, and the Centers for Medicare & Medicaid Services, which would be responsible for collecting, safeguarding, and publishing the data. Medicare beneficiaries, researchers, policymakers, and health care analysts would be affected indirectly, gaining greater visibility into how MA supplemental benefits—such as vision, dental, or other extra benefits—are used and paid for.
The bill was introduced on September 10, 2025, by Rep. Jennifer McClellan and referred to the House Committees on Ways and Means and Energy and Commerce. It has not yet been voted on, and further committee action would be required before it could advance to the full House.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Timeline
25 Jun 2026
Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote.
Common questions
- What does H.R. 5243 do?
- H.R. 5243 would amend the Social Security Act to require Medicare Advantage (MA) organizations to submit detailed, enrollee-level data on the supplemental benefits offered under their plans. Beginning with plan years starting on or after January 1, 2029, MA organizations would have to report data by item, service, or benefit category, and by provider identifier, including who is eligible for benefits, what types are offered, and utilization and payment information, such as total plan spending and out-of-pocket costs per enrollee. Starting in 2030, the Secretary of Health and Human Services would make this data available annually—both to researchers and analysts for program evaluation and health care research, and to the public through a data file posted online, with safeguards to protect individually identifiable information. The bill primarily affects Medicare Advantage organizations, which would face new federal reporting requirements, and the Centers for Medicare & Medicaid Services, which would be responsible for collecting, safeguarding, and publishing the data. Medicare beneficiaries, researchers, policymakers, and health care analysts would be affected indirectly, gaining greater visibility into how MA supplemental benefits—such as vision, dental, or other extra benefits—are used and paid for. The bill was introduced on September 10, 2025, by Rep. Jennifer McClellan and referred to the House Committees on Ways and Means and Energy and Commerce. It has not yet been voted on, and further committee action would be required before it could advance to the full House.
- Has H.R. 5243 become law?
- The source does not supply a confirmed lifecycle stage for H.R. 5243. Check the latest action and official source below.
- Who sponsored H.R. 5243?
- H.R. 5243 was sponsored by Rep. McClellan, Jennifer L. [D-VA-4] (D-VA), with 1 cosponsor.
- What's the latest action on H.R. 5243?
- Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote. (25 Jun 2026).
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