H.R. 10747 – Puerto Rico Medicare Advantage Fairness Act of 2026

AI-Generated Summary

Updated October 8, 2026 at 3:13 AM UTC

The Puerto Rico Medicare Advantage Fairness Act of 2026 changes the way Medicare Advantage payment benchmarks are adjusted for Puerto Rico. Starting in 2027, the geographic cost adjustment used for Puerto Rico will be set equal to the adjustment used for the U.S. Virgin Islands. This affects the amount Medicare pays private insurers for Medicare Advantage plans serving Puerto Rican beneficiaries.

Key Provisions

Amends the Social Security Act to add a rule that, for each year beginning on or after Jan. 1, 2027, the geographic adjustment applied to Medicare Advantage payment areas in Puerto Rico must be the same as the adjustment applied to payment areas in the U.S. Virgin Islands.

Legislative Activity

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HouseIntro Referral Latest Action

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.

Ways and Means Committee

October 5, 2026

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HouseIntro Referral

Introduced in House

October 5, 2026

HouseIntro Referral

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.

Ways and Means Committee

October 5, 2026

Bill Text

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Introduced in HouseIssued October 5, 2026

I

119th CONGRESS

2d Session

H. R. 10747

IN THE HOUSE OF REPRESENTATIVES

October 5, 2026

Mr. Ruiz (for himself, Mr. Bilirakis, Mr. Hernández, and Mr. Soto) introduced the following bill; which was 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 BILL

To amend title XVIII of the Social Security Act to ensure appropriate geographic adjustments to Medicare Advantage benchmarks in Puerto Rico.

1.

Short title

This Act may be cited as the Puerto Rico Medicare Advantage Fairness Act of 2026.

2.

Ensuring appropriate geographic adjustments to Medicare Advantage benchmarks in Puerto Rico

Section 1853(c)(1)(D)(i) of the Social Security Act (42 U.S.C. 1395w–23(c)(1)(D)(i)) is amended by adding at the end the following new sentence: For each year specified in clause (ii) beginning on or after January 1, 2027, in determining the adjusted average per capita cost for such year for an MA payment area in Puerto Rico under the preceding sentence, the average geographic adjustment applied to such area for such year shall be equal to such adjustment applied to an MA payment area in the United States Virgin Islands for such year..