Apples to Apples Comparison Act of 2026
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Progress
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- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The Apples to Apples Comparison Act of 2026 aims to increase transparency in Medicare spending by requiring the Department of Health and Human Services to publish detailed expenditure data. Starting in 2027, the agency will release information broken down by county, Metropolitan Statistical Area, and various categories of Medicare beneficiaries, including those enrolled in traditional Medicare, Medicare Advantage plans, and prescription drug plans. The act also directs the Medicare Payment Advisory Commission (MedPAC) to analyze and report on the differences in expenditures between Medicare Advantage and traditional Medicare plans, considering factors like benefits offered and patient demographics.
Key provisions
- Requires the Department of Health and Human Services to publish Medicare expenditure data by county and Metropolitan Statistical Area, starting in 2027.
- Mandates the publication of data broken down by categories of Medicare beneficiaries (Part A, Part B, Medicare Advantage, prescription drug plans, etc.).
- Directs the Centers for Medicare & Medicaid Services to make this data available in machine-readable files.
- Requires MedPAC to conduct retrospective analyses comparing Medicare Advantage and traditional Medicare expenditures.
- Instructs MedPAC to consider factors like benefits offered, patient demographics, and HCC risk scores in its analyses.
- Requires the Boards of Trustees to include expenditure information in their annual reports, broken down by beneficiary categories.
- Establishes a timeframe for the publication of expenditure data (30 days after the end of each year, beginning with 2027).
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