H.R. 5243 — To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

This section requires Medicare Advantage (MA) organizations to submit enrollee-level data on supplemental benefits—by item or service (or category), national provider identifier, eligibility, benefit categories offered, utilization, plan payments (total amount spent per utilizing enrollee), and enrollee out-of-pocket costs per utilization—to the Secretary for each MA plan, beginning with plan years on or after January 1, 2029. (As background, MA plans under Medicare Part C provide supplemental benefits such as dental, vision, and hearing coverage beyond original Medicare Parts A and B.) It further directs the Secretary, beginning in 2030, to make such data available on the first Monday in October each year to individuals and entities for Medicare program evaluations and health care research; to post a public use data file by October 1 each year on the CMS website; and to ensure confidentiality procedures for individually identifiable enrollee information. This section includes a rule of construction clarifying that it does not affect the information collection proposed in the March 14, 2023, Federal Register notice (88 Fed. Reg. 15726).