Representatives Greg Landsman (D-OH) and Bob Onder (R-MO) on September 15, 2026, introduced the bipartisan Protecting Approved Care Act, which is aimed at preventing Medicare Advantage (MA) plans from retroactively denying or reducing payment for care that has already been approved and delivered. The bill would apply protections to prior authorizations, pre-service and concurrent determinations, and authorizations for transfers from hospitals to post-acute care settings.
LeadingAge appreciates the bill’s focus on practices our nonprofit and mission-driven members increasingly encounter, including plans denying or making only partial payment for previously approved services and seeking lower payments than CMS-required assessments indicate. Providers should be able to rely on an MA plan’s approval when they furnish care in good faith rather than face burdensome appeals or legal action after services have already been delivered. LeadingAge is reviewing the legislation and its implications for members and will continue engaging with Congress on policies that ensure MA plans appropriately cover and pay for needed care.