Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, 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.
The Prior Authorization Accountability Act requires health insurance plans and insurers to publicly report detailed information about their prior authorization practices starting in 2027. Prior authorization is the process where insurers must approve certain medical treatments before they are provided. The bill mandates that plans disclose approval and denial rates for prior authorizations, broken down by specific medical services, as well as how often denied requests are successfully appealed. Plans must also report how long it takes to make prior authorization decisions and disclose whether they use artificial intelligence or other automated technology to make these determinations. The legislation applies to employer-sponsored health plans and individual insurance markets, with reporting requirements submitted to the federal government and posted on plan websites so consumers can compare how different insurers handle prior authorization requests. Additionally, starting in 2029, health insurance marketplaces established under the Affordable Care Act must include this prior authorization data in their plan comparison tools to help people make informed choices when selecting coverage.
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