Federal Advocate Articles
Sen. Marshall Introduces Bipartisan Bill to Improve Medicare Advantage

Medicare Advantage 3 (April 28, 2026) - U.S. Sen. Roger Marshall (R-KS), alongside Sen. Sheldon Whitehouse (D-RI), recently introduced bipartisan legislation to improve the Medicare Advantage program by addressing administrative barriers that can delay patient care.

The Medicare Advantage Improvement Act (S. 4384/HR. 8375) focuses on reforming prior authorization requirements and other standards within MA plans - an area that continues to present challenges for both providers and patients. Among other provisions, the bill would require the Centers for Medicare & Medicaid Services to evaluate and standardize prior authorization practices and reduce unnecessary administrative burden, while also creating pathways to exempt certain providers participating in value-based care arrangements.

The Medicare Advantage Improvement Act would:

  • Requires standard prior authorization approvals within 72 hours, expedited decisions within 24 hours and real-time approvals for routine low-risk services integrated with electronic health records – and once care is approved, plans cannot require new authorizations mid-treatment.
  • Once a service is authorized, coverage cannot be retroactively denied. Automated denial algorithms are prohibited, and the bill would establish prompt-pay protections to ensure providers are reliably compensated for approved care.
  • Requires MA plans to report prior authorization data publicly.
  • Prevents MA plans from applying stricter medical necessity standards than original Medicare.
  • Strengthens network adequacy requirements for rehabilitation hospitals and long-term care hospitals.

These changes are intended to streamline care delivery, reduce delays and allow clinicians to spend more time with patients rather than navigating complex approval processes. The Kansas Hospital Association supports efforts to improve the functionality of the Medicare Advantage program and reduce administrative burden on providers, while ensuring patients have timely access to medically necessary care. We will continue to monitor this legislation and engage with the Kansas Delegation as it moves through Congress.