PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
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People & committees
Rep. Kelly, Mike [R-PA-16] · R–PA
Legislative record
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Sep 28, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-21 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This bill would change how Medicare Advantage contracts receive five-star quality ratings starting in the 2031 contract year. It would remove certain measures from rating calculations, including measures judged unrelated to care quality or patient experience and measures based on surveys that are too long or insufficiently representative. The changes would affect organizations whose contracts are rated and people enrolled in those contracts. Two expert panels would recommend improvements to surveys and rating methods, and annual public reports would explain ratings and excluded measures.
for the 2031 contract year and each subsequent contract year, the calculation of Star Ratings for such year shall— (1) exclude any measure that—
(A) the Secretary determines is not related to clinical quality, patient outcomes, or patient experience for individuals enrolled under the contract;
(C) is based on data from a survey distributed to individuals enrolled under the contract if such survey— (i) includes more than 10 questions; (ii) does not yield responses from a geographically, demographically, and socioeconomically diverse set of individuals; or (iii) fails to meet such minimum response, sampling, or representativeness criteria as the Secretary determines necessary to implement clause (ii);
The Secretary shall establish a technical expert panel, consistent with subsection (e), to evaluate and recommend the use of statistically sound beneficiary survey instruments as data sources for measures in the Star Ratings program.
The Secretary shall establish a technical expert panel, consistent with subsection (e), to evaluate the methodology for calculating measure-level cut points and assigning overall Star Ratings.
the Secretary shall make publicly available a report describing the distribution of overall Star Ratings and the methodology used to establish cut points and assign such ratings for such contract year. Such report shall also include— (1) a list of measures excluded from the calculation of Star Ratings for such contract year;
The proposed law is called the MA STARS Act. It would require the Secretary of Health and Human Services to revise specified Medicare Advantage rating regulations through rulemaking that allows public comment. The revised rating calculations would apply to the 2031 contract year and every subsequent contract year.
This Act may be cited as the Medicare Advantage Strengthening Transparency and Accountability in Rating Systems Act or the MA STARS Act.
The Secretary of Health and Human Services shall, through notice and comment rulemaking, revise sections 422.160 through 422.166 of title 42, Code of Federal Regulations, to provide that, in implementing the Star Ratings program with respect to an MA-only contract or an MA–PD contract, for the 2031 contract year and each subsequent contract year, the calculation of Star Ratings for such year shall—
Rating calculations would exclude measures the Secretary finds unrelated to clinical quality, patient outcomes, or patient experience. They would also exclude measures the Secretary finds cannot reasonably be attributed to actions of the insurer and entities carrying out delegated functions, consistent with program guidance.
(1) exclude any measure that— (A) the Secretary determines is not related to clinical quality, patient outcomes, or patient experience for individuals enrolled under the contract; (B) the Secretary determines is not reasonably attributable to actions of the issuer and its delegated entities, consistent with program guidance;
The term delegated entity means any provider, provider organization, subcontractor, or other entity to which an issuer delegates functions related to benefits administration, utilization management, quality improvement, or enrollee services.
A survey-based measure would be excluded if the survey has more than 10 questions, fails to obtain responses from people with diverse geographic, demographic, and socioeconomic backgrounds, or fails the Secretary’s minimum standards for responses, sampling, or representativeness. Any one of these conditions would trigger exclusion.
(C) is based on data from a survey distributed to individuals enrolled under the contract if such survey— (i) includes more than 10 questions; (ii) does not yield responses from a geographically, demographically, and socioeconomically diverse set of individuals; or (iii) fails to meet such minimum response, sampling, or representativeness criteria as the Secretary determines necessary to implement clause (ii);
The Secretary would exclude a measure if it is no longer competitive for most covered contracts and keeping it would not distinguish their performance. These measures would remain publicly reported as display-only measures, meaning they would be shown without counting toward the rating calculation.
(D) the Secretary determines is no longer competitive as a metric for the majority of MA-only contracts and MA–PD contracts, and the continued inclusion of which would not differentiate performance among such contracts;
(3) with respect to any measure excluded under paragraph (1)(D), include such measure in the Star Ratings program as a display-only measure, including by publicly reporting performance on such measure in a form and manner determined appropriate by the Secretary.
New rating measures could be included only if the Secretary finds them related to clinical quality, patient outcomes, or patient experience. An existing measure would count as newly added only if the Secretary designates it that way because its specifications changed materially.
(2) only include measures newly added to the Star Ratings program for such year that the Secretary determines are related to clinical quality, patient outcomes, or patient experience;
The term newly added, with respect to a measure, means a measure first included in the Star Ratings program for the applicable contract year and does not include a measure continued from a prior year, unless the Secretary designates such measure as newly added due to a material change in specifications.
A beneficiary survey expert panel would evaluate and recommend statistically sound surveys. It would identify surveys developed, endorsed, and maintained by a third-party quality measurement organization or federal agency, relevant to care quality or patient experience, and capable of producing diverse responses. Survey design considerations would include question count and complexity, completion time, and how and when surveys are delivered.
The Secretary shall establish a technical expert panel, consistent with subsection (e), to evaluate and recommend the use of statistically sound beneficiary survey instruments as data sources for measures in the Star Ratings program.
(A) are developed, endorsed, and maintained by a third-party quality measure organization or Federal agency, such as the National Committee for Quality Assurance or the Agency for Healthcare Research and Quality; (B) have relevance to clinical quality, patient outcomes, or patient experience; (C) yield responses from a geographically, demographically, and socioeconomically diverse set of individuals;
(D) are designed to meet such minimum response, sampling, or representativeness criteria as necessary to implement subparagraph (C), with consideration for the number and complexity of questions, average time to completion, modality and timing of survey delivery, and other factors that maximize survey response rates;
The survey panel would have to seek stakeholder feedback, allow public comment, and submit its findings and recommendations to the Secretary within two years after enactment.
(2) solicit relevant stakeholder feedback on the findings of its evaluation and recommendations, and provide opportunities for public comment; and (3) not later than 2 years after the date of enactment of this section, submit to the Secretary a report summarizing the findings of the evaluation and recommendations for statistically sound beneficiary survey instruments to use as data sources for measures in the Star Ratings program.
A second expert panel would review how the program sets cut points—the thresholds used to assign ratings for individual measures—and assigns overall ratings. It would seek stakeholder feedback and public comment and report recommendations within two years after enactment. Rewarding performance and promoting competition are stated goals for those recommendations, not established results.
The Secretary shall establish a technical expert panel, consistent with subsection (e), to evaluate the methodology for calculating measure-level cut points and assigning overall Star Ratings. Such panel shall— (1) solicit relevant stakeholder feedback on the findings of its evaluation and recommendations, including opportunities for public comment; and (2) not later than 2 years after the date of enactment of this section, submit to the Secretary a report on recommendations to reform such methodology in a manner that rewards performance and promotes competition.
Before the 2031 contract year and each later contract year, the Secretary would publish a report by a date the Secretary selects. It would explain the distribution of overall ratings and the methods used to set thresholds and assign ratings. It would also list excluded measures and explain each exclusion’s legal basis and rationale, including supporting data or analysis as the Secretary considers appropriate.
For the 2031 contract year and each subsequent contract year, not later than a date determined appropriate by the Secretary prior to the beginning of such contract year, the Secretary shall make publicly available a report describing the distribution of overall Star Ratings and the methodology used to establish cut points and assign such ratings for such contract year.
Such report shall also include— (1) a list of measures excluded from the calculation of Star Ratings for such contract year; and (2) for each such excluded measure, the basis for exclusion, including the applicable provision under subsection (a)(1), and a brief description of the Secretary’s rationale for such exclusion, including any data or analysis relied upon, as determined appropriate by the Secretary.
Both panels would need balanced representation of relevant stakeholders and experts, including, as appropriate, patients, caregivers, clinicians, providers, insurers, researchers, and measurement and survey experts. The Secretary would have to consider organizations with different sizes, ownership, locations, and care delivery models, including nonprofit, provider-aligned, and locally or regionally experienced organizations.
In establishing any technical expert panel under subsection (b) or (c), the Secretary shall ensure a balanced representation of relevant stakeholders and experts, including, as appropriate, beneficiaries, caregivers, clinicians, provider organizations, facility representatives, measure developers, health insurance providers, researchers, government agencies, quality measurement experts, survey methodology experts and Medicare Advantage organizations of different sizes, ownership structures, geographic service areas, and delivery models.
Such representation shall include consideration of nonprofit and other mission-driven organizations, organizations with provider-aligned care delivery arrangements, and organizations with local and regional market experience.
The bill adopts existing regulatory definitions for the covered contract types and Star Ratings instead of reproducing those definitions. It identifies the Star Ratings program by reference to the five-star system in the Social Security Act.
The terms MA-only contract, MA–PD contract and Star Rating have the meanings given each such term in the regulations under subpart D of part 422 of title 42, Code of Federal Regulations.
The term Star Ratings program means the 5-star rating system under section 1853(o)(4) of the Social Security Act (42 U.S.C. 1395w–23(o)(4)).
The supplied action snapshot, updated September 28, 2026, records introduction in the House on September 21, 2026, and referral that day to the Ways and Means and Energy and Commerce committees for provisions within their respective jurisdictions.
Source snapshot updated 2026-09-28T15:25:30Z.
2026-09-21: Introduced in House
2026-09-21: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-09-21. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version; accompanying materials needed to assess formal earmark status were not supplied.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow preferential benefit, special exemption, or carve-out was identified in the complete supplied introduced text under the requested criteria. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Sep 28, 2026. How PlainBill uses AI