What This Bill Does
This bill would amend Medicare rules to require Medicare Advantage plans to include certain information in their encounter data submissions. The goal is to make plan-level records more complete and useful for oversight, payment accuracy, and care monitoring. It mainly affects Medicare Advantage insurers, their data systems, and the federal agencies that use this information to supervise the program. There is no direct benefit amount or dollar payment change in the title, but the bill would change how claims-like service data must be reported to Medicare.
- Requires Medicare Advantage encounter data to include certain information.
- Applies to Medicare Advantage plans and the federal Medicare program.
- Aims to improve the completeness and usefulness of plan-reported service data.
- Could strengthen oversight of payments, utilization, and care delivery.
- Likely increases administrative reporting work for plans.
Who This Bill Affects
If you are enrolled in Medicare Advantage, this bill would affect the way your plan reports your care to Medicare, which can improve oversight of how the plan performs and how accurately it is paid. You would not receive a direct cash benefit, but better data can make it easier for the government to detect missing services, billing problems, or plan administration issues that could affect access and quality. If you work for or run a Medicare Advantage plan, you would likely see added reporting requirements and administrative compliance work.
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- Bill
- HR 9392
- Congress
- 119th Congress
- Official title
- To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data.
- Policy area
- Healthcare
- Latest action
- Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (June 23, 2026)
- Last updated
- June 24, 2026
Who Supports & Opposes This
- Medicare beneficiaries Supporters argue that better encounter data helps Medicare verify that plans are providing the care they advertise and that patients are getting appropriate services. More complete records can also help identify access problems earlier.
- Federal program overseers Oversight officials and policy analysts would favor more complete data because accurate encounter records are essential for auditing plan performance, detecting improper billing patterns, and improving payment accuracy.
- Consumer advocates Advocates for seniors may support the bill because stronger reporting can make it harder for plans to hide gaps in care or underreport services, giving beneficiaries and regulators a clearer picture of plan quality.
- Medicare Advantage insurers Plans may argue that the mandate adds compliance costs, system changes, and reporting complexity, especially if the new information standards are technical or difficult to standardize across networks and vendors.
- Health plan administrators Administrators could contend that more detailed encounter data requirements increase paperwork without directly improving patient care, and that resources spent on reporting could be used instead for member services.
- Providers who work with multiple plans Doctors and billing contractors may worry that stricter data rules will create additional administrative burdens or rejected submissions if plan systems and provider documentation are not fully aligned.
Key Implications
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““require the inclusion of certain information in Medicare Advantage encounter data””
This means plans would have to submit more complete or more standardized records about the care their enrollees receive. Those records are used for oversight, so missing details can affect how well Medicare can monitor the program.
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““amend title XVIII of the Social Security Act””
Title XVIII is the part of federal law that governs Medicare. Changing it signals that the bill would permanently modify Medicare reporting requirements rather than create a temporary pilot.
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““Medicare Advantage encounter data””
Encounter data are the detailed service records that show what care was delivered to enrollees. Better data can help the government compare plan performance and payment accuracy across insurers.
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““Committee on Ways and Means””
This committee handles major Medicare financing and payment policy in the House. Referral here means the bill will be reviewed by lawmakers with jurisdiction over Medicare spending and program rules.
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““Committee on Energy and Commerce””
This committee also has jurisdiction over health policy issues. Its involvement suggests the bill may be examined for consumer protection, data reporting, and healthcare administration effects.
Latest Status
June 23, 2026
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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