The Health Claim Denial Transparency Act requires group health plans to report detailed information about claim denials in their annual reports to the Department of Labor. Plans would need to disclose the total number of claims submitted, approved, and denied each year, along with breakdowns by type of claim including prescription drugs, mental health services, and cancer treatment. The reports must also include the reasons claims were denied, whether artificial intelligence was used in processing decisions, and the dollar amounts of claims paid versus denied. The regulation applies to all group health plans, including smaller plans with fewer than 100 participants, though plans receiving 20 or fewer claims in certain specialized categories can be exempted from reporting those specific numbers. The Department of Labor must develop and issue the required regulations within one year of the bill's enactment.
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