Representatives join hospital leaders at AHA briefing to discuss need for legislation on prompt payment standard for MA plans  

Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare Advantage impact services, the workforce and patients’ access to care. Rep. Linda Sanchez, D-Calif., a sponsor of the AHA-supported Medicare Advantage Prompt Pay Act (H.R. 5454/S. 2879), appeared at the event along with Caroline Dudunakis, legislative assistant for Rep. Jodey Arrington, R-Texas, a co-sponsor. The bill would apply a federal prompt payment standard to MA plans to help ensure that healthcare providers receive timely payments from MA plans for necessary patient services. It calls for plans to pay at least 95% of clean claims within 14 days for in-network claims and 30 days for out-of-network claims. Hospital and health system leaders spoke on why the measure is needed.

“Hospitals are always there for patients — we deliver care in urgent, often life-threatening situations without hesitation,” said Erik G. Wexler, president and CEO of Providence Health and Services in Renton, Wash., and an AHA trustee. “But too often, we’re not paid on time for care that has already been provided, creating instability that ultimately affects patients and the providers who care for them. The Medicare Advantage Prompt Pay Act is a reasonable, bipartisan solution to ensure patients can rely on timely care and providers can count on timely payment.” 

Other hospital and health system representatives that participated in the event included Lorin Martin, representing Westchester Medical Center Health Network in Valhalla, N.Y., Collin McLarty, CEO of Cogdell Memorial Hospital in Snyder, Texas, and Josh Reeves, vice president of development and advocacy at Ozarks Healthcare in West Plains, Mo.