H.R. 5873: Prompt Reporting and Oversight for Medicare Providing Transparency Act

The bill titled the "Prompt Reporting and Oversight for Medicare Providing Transparency Act," also referred to as the "PROMPT Act," aims to amend the Social Security Act regarding Medicare. The main focus of this bill is to ensure that the Secretary of Health and Human Services is required to provide an explanation of benefits (EOB) to Medicare beneficiaries within a specific time frame.

Key Provisions

• The bill mandates that beneficiaries receive an explanation of benefits no later than 30 days after they receive a medical item or service that is covered under the Medicare program.
• It alters the existing section of the Social Security Act to specify that the explanation must detail the payments that were made or would have been made for the services provided.

Purpose of the Bill

The purpose of the bill is to enhance transparency within the Medicare program. By requiring timely communication of the explanation of benefits, it aims to improve beneficiaries' understanding of their healthcare costs, including what is covered, what they may owe, and how various services impact their out-of-pocket expenses.

Implications

Should the bill pass, it could lead to better financial planning for Medicare beneficiaries by allowing them to receive information about their healthcare costs more promptly. It may help reduce confusion about charges related to medical services and empower beneficiaries with knowledge about their benefits.