Health Claim Denial Transparency Act

This bill would require the Secretary of Labor, within 1 year, to issue a rule requiring all employer group health plans to report claim data in their annual reports. Plans would report how many claims were submitted, approved, denied, and appealed, including by type such as prescription drugs, mental health and substance use, and cancer care. Plans would also report dollar amounts paid and denied, reasons for denials, late decisions, and how many claims involved artificial intelligence or automated tools. Plans with fewer than 100 participants would also have to report, but plans with 20 or fewer claims in certain categories would not report those categories.

Full text and official record on Congress.gov

Sponsors

• Lucy McBath Democrat sponsor
• 0 cosponsors