I 
119TH CONGRESS 
1ST SESSION H. R. 5243 
To amend title XVIII of the Social Security Act to increase data transparency 
for supplemental benefits under Medicare Advantage. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 10, 2025 
Ms. MCCLELLAN introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to increase 
data transparency for supplemental benefits under Medi-
care Advantage. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. INCREASING DATA TRANSPARENCY FOR SUP-
PLEMENTAL BENEFITS UNDER MEDICARE 
ADVANTAGE. 
(a) IN GENERAL.—Section 1857(e) of the Social Se-
curity Act (42 U.S.C. 1395w–27(e)) is amended by adding 
at the end the following new paragraph: 
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‘‘(6) REPORTING
OF
ENROLLEE-LEVEL
DATA 
ON SUPPLEMENTAL BENEFITS.— 
‘‘(A) IN GENERAL.—Beginning with plan 
years beginning on or after January 1, 2029, a 
contract under this section with an MA organi-
zation shall require the organization to submit 
to the Secretary, for each MA plan offered by 
the organization, enrollee-level data on supple-
mental benefits (by item or service, or category 
of item or service, as determined appropriate by 
the Secretary, and national provider identifier), 
including eligibility for such benefits, the types 
of benefit categories offered, data on utilization 
of and payments for such benefits (including 
the total amount spent by the plan for each en-
rollee who utilized such benefits and the total 
out-of-pocket cost per utilization for each en-
rollee). 
‘‘(B) DATA ACCESS.— 
‘‘(i) IN GENERAL.—On the first Mon-
day in October of each year (beginning 
with 2030), the Secretary shall make data 
submitted under subparagraph (A) avail-
able to individuals and entities for the pur-
pose of conducting— 
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‘‘(I) evaluations and other anal-
ysis to support the program under 
this title; and 
‘‘(II) other health care related re-
search. 
‘‘(ii) PUBLIC
USE
DATA
FILE.—Not 
later than October 1 of each year (begin-
ning with 2030), the Secretary shall make 
a public use data file containing the data 
submitted under subparagraph (A) avail-
able on the internet website of the Centers 
for Medicare & Medicaid Services. 
‘‘(iii) CONFIDENTIALITY.—In making 
data available under this subparagraph, 
the Secretary shall have in place proce-
dures to safeguard the privacy of any indi-
vidually identifiable enrollee information.’’. 
(b) RULE
OF
CONSTRUCTION.—Nothing in the 
amendments made by this section shall affect the collec-
tion of information as proposed pursuant to the notice en-
titled ‘‘Agency Information Collection Activities: Proposed 
Collection; Comment Request’’, published in the Federal 
Register on March 14, 2023 (88 Fed. Reg. 15726). 
Æ 
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