A Democratic bill with no cosponsors
Last activity — Referred to the House Committee on Education and Workforce.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The Health Claim Denial Transparency Act directs the Secretary of Labor to create new regulations for group health plans. These regulations would require plans to include specific information regarding claim denials in their annual reports. The requested data includes totals for submitted, approved, denied, and appealed claims across various categories like prescription drugs, mental health, and cancer treatment. It also requires reporting on the reasons for denials and the use of artificial intelligence in processing claims. Additionally, the bill mandates reporting on claims that were not adjudicated within required time frames.
Yes· 3 of 7
- Scored +5
Does this give people more protection from unfair business practices?
The bill increases transparency by requiring health plans to report specific data on claim denials and the use of artificial intelligence in decision-making.
- Scored +5
Does this make what the government does easier for the public to see?
The bill increases transparency regarding how health plans process and deny claims through required annual reports.
- Scored +4
Would people with disabilities be better off under this?
The requirement to report denial reasons and automated decision-making can help identify potential barriers to care for those with disabilities.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
-
Increased Transparency on Denials: Group health plans would be required to report the total number of claims submitted, approved, denied, and appealed, as well as the number of denials reversed during appeals (Section 2(a)(1)(A)).
-
Specific Insight into Medical Categories: Plans must provide data on specific types of care, including urgent care, in-patient, out-patient, prescription drugs, mental health and substance use disorder benefits, and cancer treatment (Section 2(a)(1)(B, D, E, F)).
-
Clarity on Denial Reasons: The bill requires plans to report the basis for denials, such as medical necessity, lack of referral, lack of prior authorization, excluded services, or administrative reasons (Section 2(a)(1)(I)).
-
Accountability for Automated Decisions: Plans must disclose the number of claims processed using artificial intelligence or other automated decision-making tools, including how many were paid or denied (Section 2(a)(1)(J)).
-
Timeliness Tracking: The regulation requires reporting the number of claims that were not adjudicated within the time frame required by the plan's claims procedure (Section 2(a)(1)(H)).
Potential Negative Impacts for People
- Exceptions for Small Plans: Certain data regarding prescription drugs, mental health, and cancer treatment may not be included in the annual reports of plans that have received 20 or fewer unique claims in those categories (Section 2(a)(2)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would people with disabilities be better off under this? — The requirement to report denial reasons and automated decision-making can help identify potential barriers to care for those with disabilities. Would households on low incomes be better off under this? — Increased transparency of claim denials can help low-income households better understand and challenge insurance barriers.
- Healthcare
- Does this make mental health care easier to get? — The bill requires reporting on mental health and substance use disorder claim denials to increase visibility into access barriers. Does this strengthen the Affordable Care Act? — The bill enhances oversight of group health plans through mandatory disclosure of denial statistics and reasons.
- Economy And Finance
- Does this give people more protection from unfair business practices? — The bill increases transparency by requiring health plans to report specific data on claim denials and the use of artificial intelligence in decision-making.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill increases transparency regarding how health plans process and deny claims through required annual reports.
- Education And Technology
- Does this put more rules on large technology companies? — The bill mandates disclosure of how artificial intelligence and automated tools are used to process and deny health insurance claims.
- 7/16/2026
- Referred to the House Committee on Education and Workforce.
- Introduced in House