U.S. Congress legislation · 119th Congress
HB10394: Protecting Approved Care Act
Status: In committee, September 15, 2026
To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization and claims denial under Medicare Advantage plans.
What the bill says
To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization and claims denial under Medicare Advantage plans.
From the introduced text, September 15, 2026:
A BILL To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization and claims denial under Medicare Advantage plans. SECTION 1. Short title This Act may be cited as the Protecting Approved Care Act . SECTION 2. Establishing requirements with respect to the use of prior authorization and claims denial under Medicare Advantage plan Section 1857(e) of the Social Security Act ( 42 U.S.C. 1395e-27(e) ) is amended by adding at the end the following new paragraph: (7) Limitations on claims denial for covered items and services (A) In general Beginning with plan years beginning on or after January 1, 2028, a contract under this section with an MA organization shall require that-- (i) in the case that the MA organization approves the furnishing to an individual enrolled under an MA plan offered by such MA organization of an item or service through a specified authorization made during the receipt by the individual of such item or service, the MA organization may not, after such approval, take any of the actions described in subparagraph (B) with respect to such item or service; and (ii) in the case that there is no requirement to obtain a specified authorization with respect to an item or service for which benefits are available under …
Sponsors
- Greg Landsman (D, HD-001) · primary sponsor
- Robert Onder (R, HD-003)
- Mariannette Miller-Meeks (R, HD-001)
- Joe Wilson (R, HD-SC-2)
- Maggie Goodlander (D, HD-002)
- Eric Sorensen (D, HD-017)
Latest actions
- : 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.
- : Introduced in House
Subjects: Health
Common questions
- What is HB10394?
- HB10394 is a bill in Congress (119th Congress): Protecting Approved Care Act.
- What does HB10394 do?
- In its own words: To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization and claims denial under Medicare Advantage plans.
- What is the status of HB10394?
- In committee as of September 15, 2026. 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. (September 15, 2026).
- Who sponsored HB10394?
- Greg Landsman (D, HD-001), with 5 co-sponsors.
- Where is the official record for HB10394?
- On the Congress website: https://www.congress.gov/bill/119th-congress/house-bill/10394
Source: official Congress record. Tracked by Delilah, AI for legislation across all 50 states and Congress.