Healthcare across the country

The Health Insurance Transparency for Patients Act requires health insurance companies and Medicare Advantage organizations to publicly report detailed data on how they handle coverage requests. Starting with plan years after the law is passed, these providers must annually submit and display online information about the number and percentage of claims denied versus approved, along with the specific reasons for denials. The report must also break down data by the review method used, such as automated systems or human reviewers, and include the time it took to reach a decision. Additionally, the bill mandates that these organizations list all services requiring prior authorization and publish this information in a simple, easy-to-understand format. The Department of Health and Human Services will also make this data available on its own website to ensure public access.

The Tax Exempt Hospital Transparency Act requires large and high-revenue nonprofit hospitals to submit detailed annual reports to the IRS regarding their financial assistance, community health initiatives, and operational spending. Specifically, these organizations must disclose how they address identified community health needs, the value of financial aid provided, and the numbers of applications granted or denied. The bill also mandates that larger hospitals break down their spending on quality improvement, nonclinical programs, and specific health service lines, while high-revenue facilities must report advertising costs and data related to the 340B drug discount program. These reporting requirements are designed to increase transparency for taxpayers and the public by providing concrete data on how tax-exempt hospitals use their resources and serve their communities.