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What the bill would do
The Medicare Advantage Prompt Pay Act, H.R. 5454 in the House and S. 2879 in the Senate, would require plans to pay at least 95% of clean claims within 14 days for in-network services and within 30 days for out-of-network services. Rep. Linda Sánchez, a California Democrat, sponsors the House bill, and Rep. Jodey Arrington, a Texas Republican, is a co-sponsor. The American Hospital Association supports it.
At an AHA briefing in Washington on June 3, executives from Providence, Westchester Medical Center Health Network, Cogdell Memorial Hospital and Ozarks Healthcare described how payment delays affect services, the workforce and patient access. The speakers ranged from a large multistate system to smaller community hospitals, a reminder that delays affect organizations of every size and that those with thin cash reserves feel them first.
The briefing came a day after the AHA released an affordability blueprint that lists reducing administrative waste among its five focus areas, alongside care delivery, drug and device costs, community health and innovation.
Why the timing matters
Medicare Advantage now covers a large and growing share of hospital Medicare volume. Many systems are already managing tighter cash as payer mix shifts and expenses rise. When a growing payer class pays slowly, days in accounts receivable climb, borrowing needs rise and staff time shifts from patient-facing work to follow-up and appeals.
Passage is uncertain. Even so, the debate gives hospitals a chance to show lawmakers and regulators specific evidence of how plan behavior affects operations.
Build the evidence base
- Measure time to payment for clean claims by MA plan and product, compared with traditional Medicare and commercial payers.
- Track pended and partially paid claims, including requests for records that arrive after services are approved.
- Quantify the cash effect: the dollars tied up beyond 14 and 30 days at any point, and the staff hours spent chasing them.
- Share results with your state association and congressional delegation, using patient access examples where delays affected services.
- Use the data in contracting. Payment timeliness terms, interest on late payments and escalation paths can be negotiated now, regardless of what Congress does.
Archive entry for Jun 10, 2026, added Nov. 11, 2026.