LeadingAge National Government News: July 23, 2025

LeadingAge endorsed the bipartisan “Prompt and Fair Pay Act” (H.R. 4559) introduced by Reps. Lloyd Doggett (D-TX) and Greg Murphy (R-NC) on Monday, July 21. This bipartisan bill would require Medicare Advantage (MA) plans to pay their contracted providers at least the current Medicare fee-for-service (FFS) reimbursement rates as the rate floor and establishes prompt pay timelines. Nothing prohibits plans from paying more than Medicare FFS rates. Establishing a rate floor that MA plans must pay has been a top advocacy priority for LeadingAge as it is critical to ensuring our skilled nursing facility and home health agency members’ financial sustainability while also giving them some bargaining power with MA plans.  

The bill also establishes prompt pay timelines for in-network providers, which have been lacking, and permits interest penalties to be assessed when plans don’t pay promptly. Plans would be required to pay their contracted providers within 14 calendar days of receipt of a clean claim submitted electronically and 30 days for other claims. In addition, plans would be required to notify providers within 10 days if the claim is considered not clean and explain what steps would be needed to correct it. Out of network providers already have regulatory protections that require MA plans to pay them at least Medicare FFS reimbursement rates and pay clean claims within 60 days.  

In the bill’s press release,  Katie Smith Sloan said,  

“To Congress and to regulators, we’ve repeatedly expressed concerns that Medicare Advantage plans, by underpaying and delaying provider reimbursement, are threatening the financial stability of our nonprofit and mission-driven provider members, which jeopardizes access to necessary care and services for older adults. This legislation, which establishes a rate floor and prompt payment requirements, is a vital step toward ensuring that providers are fairly and promptly compensated for the care they deliver. It will bring much-needed financial stability to our nursing homes and home health members–particularly those located in underserved and rural communities. We strongly support this legislation and urge its swift passage.”  

Members can access a bill fact sheet, and the bill text for more details. Here is the link to the LeadingAge article. Contact Nicole Fallon with any questions. 

The deadline for Skilled Nursing Facilities (SNFs) to complete the off-cycle revalidation has been extended from August 1 to January 1, 2026. This change was first noticed through the SNF Disclosures HelpDesk in response to provider inquiries. CMS has since updated MLN Connects and is working to update the Provider Enrollment website. LeadingAge hosted webinars in February and July and members can access recordings of these webinars on the LeadingAge Learning Hub. 

On July 21, the Centers for Medicare & Medicaid Services (CMS) notified to Medicare providers that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2024, which will affect their FY 2026 Annual Payment Update (APU). Non-compliance notifications are distributed by the Medicare Administrative Contractors (MACs) and were placed into a hospice’s CASPER folders in QIES, and into skilled nursing facility’s My Reports folders in the iQIES. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 26, 2025. 

The Quality in Assisted Living Collaborative (QALC) announced the release of proposed Emergency Preparedness guidelines for assisted living communities on July 21. As part of its commitment to fostering excellence and safety, the QALC is inviting input from stakeholders and other interested parties during a 45-day comment period. The QALC welcomes all stakeholders, including assisted living providers, regulators, policymakers, and advocacy organizations, to participate in the comment period and contribute their insights to shape the final Emergency Preparedness guidelines. Input from a broad spectrum of voices is vital to ensuring the effectiveness and relevance of the guidelines. All written comments received by the due date will be considered by QALC’s Emergency Preparedness Workgroup as the next step in the guideline’s development process. QALC is comprised of LeadingAge, the National Center for Assisted Living, Argentum, American Seniors Housing Association, and the National Association for Regulatory Administration. Comments can be submitted using this QALC Comment Form by September 8, 2025, or you can share your feedback with Kylee Childs. 

The Centers for Disease Control and Prevention (CDC) has published an Information Collection Request in the Federal Register pertaining to the National Healthcare Safety Network (NHSN). Federal agencies, including CDC, are required to estimate burdens associated with collecting information. Providers may wish to comment through this information collection request on the accuracy of CDC’s estimate of the burden associated with various NHSN reporting requirements. Comments will be accepted through www.regulations.gov until September 16. Send your feedback to Kylee Childs by August 15. 

Here is your Weekly Home Health Recap.  

Here is your Weekly Medicaid, HCBS, and PACE Recap. 

Here is your Weekly Life Plan Community Recap. 

Here is your Weekly Nursing Home Recap. 

Here is your Weekly Affordable Housing Recap. 

Here is your Weekly Hospice Recap.