Congressman Troy Downing (R-MT) on May 11, 2026, introduced HR 8726, the Protecting Authority and Restoring Tools Necessary for Enforcement by Regulatory States Act of 2026.

The bill gives to states the authority to ensure that Medicare Advantage (MA) organizations offering plans in their state follow federal regulations related to MA.

The legislation also requires the Health and Human Services (HHS) secretary to coordinate the state enforcement of MA regulations and permits this coordination to occur via a collaborative enforcement agreement.

HR 8726 does not define the structure or content of such an agreement.  Several states’ attorneys general have been asking for such authority.

The bill itself is very short; it is unclear whether the language also allows states to ensure MA plans are following Medicare regulations on required coverage for specific services  and prohibitions on plans’ developing their own internal coverage criteria.

LeadingAge has been pushing for better MA compliance and federal enforcement of the regulations to ensure timely beneficiary access to Medicare covered services and a lower burden on providers. For this reason, we support efforts to bring more enforcers into the oversight activity and think it is appropriate for states to undertake this activity, as long as there is coordination and aggregation of enforcement activities to identify broader non-compliance issues and trends, nationally.