H.R. 9396 · In committee · Health

Prior Authorization Accountability Act

What it does

Requires group health plans and health insurance issuers to publicly disclose the percentage and number of prior authorization requests approved and denied in initial determinations, both in aggregate and by item or service, beginning plan years on or after January 1, 2027.
Mandates submission and public disclosure of data on denial rates for prior authorization requests that were appealed, including the percentage and number of appeals resolved in approval at each level of appeal including judicial review.
Requires plans and issuers to publicly disclose the average and median amount of time in hours between prior authorization request submission and determination for each item or service.
Requires disclosure and description of any decision support technology, artificial intelligence, machine-learning, clinical decision-making, or other technology used to approve or deny prior authorization requests.
Applies transparency requirements to group health plans, health insurance issuers offering group or individual coverage, and coverage offered through Affordable Care Act Exchanges, with submissions to the Secretary at a time and manner specified by the Secretary.

Jun 25, 2026: Forwarded by Subcommittee to Full Committee by Voice Vote.

Committee: House Health Subcommittee