H.R. 6031 — Medicare Advantage Integrity Act of 2025

This section establishes a floor of 0.70 on the average geographic adjustment used to calculate the adjusted average per capita cost under Medicare cost contract rules (for purposes of the Medicare Advantage [MA] base payment amount) for 2026 and subsequent years. (As background, MA blended benchmarks cap per enrollee payments to private MA plans and incorporate county-level fee-for-service spending with geographic adjustments for input prices; this floor limits reductions in low-MA-penetration areas.) It further requires that at least 50% of any increase in the blended benchmark amount due to this floor be used for payments for basic benefits (i.e., coverage equivalent to original Medicare Parts A and B).