Lawmakers introduced the Medicare Advantage Improvement Act of 2026 to tighten prior authorization rules, boost transparency and curb practices that delay care.

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Lawmakers and health experts convened on Capitol Hill this week to discuss the use of AI in healthcare. They highlighted the technology’s potential to reduce administrative burdens and boost care access in rural areas — while also warning about oversight gaps and the risks of AI-driven prior authorization.

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U.S. Representative Frank Pallone, Jr. (D-New Jersey) announced that he is looking into high prior authorization denial rates by Medicaid managed care health plans. It follows a report by the Office of Inspector General that found that Medicaid MCOs denied one out of every eight prior authorization requests in 2019.

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The Medicaid Staffing Flexibility and Protection Act was introduced by Representative Earl L. “Buddy” Carter (R-Georgia) and Representative Neal Dunn (R-Florida). It would allow state Medicaid agencies to hire outside contractors to help with Medicaid redeterminations, as many agencies don’t have the workforce to handle the return to the redetermination process.

The post House Reps Introduce Bill To Ease State Medicaid Staffing Shortages Amid Redeterminations appeared first on MedCity News.

A bipartisan group of House representatives introduced the Drug Price Transparency in Medicaid Act on Friday. The bill would ban spread pricing in Medicaid programs.

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The Act, along with mandating the adoption of electronic prior authorization, requires greater levels of transparency, approval rates, and rationale for denied requests.

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The House voted 230-192, mostly along party lines, for the Elijah E. Cummings Lower Drug Costs Now Act. The Trump administration has indicated it would veto the bill and stated that it would harm innovation.

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In testimony Wednesday, former Trump attorney Michael Cohen testified he had spoken to Novartis six times. Rep. Mark Meadows issued a referral for criminal investigation over contacts with Novartis and Kazakhstan’s BTA Bank.

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The legislation, which has drawn criticism from researchers, patient advocates and industry, would enable patients to request experimental drugs while bypassing the FDA.

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The votes are in, and the House has narrowly passed the AHCA, the GOP’s plan to repeal and replace the ACA. Next stop? The Senate.

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