Protecting Patients from Automated Denials Act

Sponsor: Herbert C. Conaway (Democratic-NJ)July 16, 2026

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.

Requires human doctors to review Medicare Advantage denials made by AI, giving patients and providers more transparency.

This bill would require human doctors to review and approve any Medicare Advantage denial made using artificial intelligence. It would give patients and their doctors more information about these denials and a chance to discuss them with the reviewing physician. These new rules would take effect for plans starting in 2027.

What Would Change

Today, Medicare Advantage plans can use artificial intelligence to help deny requests for medical services without specific federal rules for human review or transparency. If this bill becomes law, starting in 2027, any AI-based denial would need a human doctor's approval and a signed statement from that doctor. There would also be clear disclosures to patients and their providers about the AI's involvement.

Key Provisions

Prohibits Medicare Advantage plans from denying a prior authorization request based on artificial intelligence output unless a qualified human doctor reviews and approves it.
Requires the reviewing doctor to sign a statement confirming they used their own medical judgment, not AI, to make the denial decision.
Mandates that Medicare Advantage plans tell patients and their doctors if AI was used in a denial and provide the reviewing doctor's information.
Gives patients' doctors the chance to talk directly with the reviewing doctor about the reasons for a denial.
Requires Medicare Advantage plans to keep records of AI-based denials for at least 10 years.

View on Congress.gov

HR 9734 · 119th Congress · July 16, 2026 · AI Summary by gemini-2.5-flash · 8/10

Protecting Patients from Automated Denials Act

What Would Change

Key Provisions

Lobbying Activity