Health Claim Denial Transparency Act

Sponsor: Lucy McBath (Democratic-GA)July 16, 2026

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Referred to the House Committee on Education and Workforce.

Requires health plans to share detailed data on denied claims and how AI is used.

This bill would require group health plans to report detailed information about denied claims. They would share why claims are denied, how many are appealed, and if they use artificial intelligence in decisions. This aims for more transparency for people with these plans.

What Would Change

Today, group health plans submit annual reports, but these reports do not include detailed information about claim denials, their reasons, or if artificial intelligence is used. If this bill passes, these plans would have to report comprehensive data on all claims, including how many are denied, why, and how many are appealed. They would also need to disclose their use of automated decision-making tools in processing claims.

Key Provisions

Requires the Department of Labor to create new rules for health plans to report claim denial data within one year.
Requires health plans to report how many claims they get, approve, deny, and how many denials are overturned on appeal.
Requires health plans to report specific denial data for prescription drugs, mental health, substance use, and cancer treatments.
Requires health plans to explain the reasons for each denial, such as medical necessity or missing prior approval.
Requires health plans to report if they use artificial intelligence to process claims and how those claims are decided.
Requires even small group health plans (under 100 participants) to follow these new reporting rules.

View on Congress.gov

HR 9754 · 119th Congress · July 16, 2026 · AI Summary by gemini-2.5-flash · 9/10

Health Claim Denial Transparency Act

What Would Change

Key Provisions

Lobbying Activity