To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to require health insurance issuers and MA organizations to make publicly available certain information with respect to coverage request rejection.
About This Bill
Committee
Latest Action · August 3, 2026
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
This bill requires health insurance companies and Medicare Advantage plans to publicly disclose detailed information about coverage denials and appeals. Specifically, insurers must report the percentage and number of claims denied on initial review, claims approved, and appeals that resulted in overturning denials, along with reasons for denials and how long decisions took. The disclosures must also specify whether denials were made through automated processes like artificial intelligence, algorithmic systems, or human review. Insurance companies and Medicare Advantage organizations must submit this deidentified information to the Department of Health and Human Services and post it on their own websites within one year of each plan year, using consumer-friendly formats established by the Secretary. The reporting requirements take effect for plan years beginning on or after January 1 of the first year following the bill's enactment, with no specific funding allocated in the legislation itself.
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