Health Claim Denial Transparency Act

The Health Claim Denial Transparency Act requires group health plans to include detailed data in their annual reports, specifically detailing the number of claims submitted, approved, denied, and appealed. This reporting covers various claim types, including prescription drugs, mental health services, cancer treatments, and those processed using artificial intelligence, while also specifying the reasons for denials such as lack of prior authorization or medical necessity. The law applies to plans with fewer than 100 participants and includes an exception for small plans that handle very few specific types of claims to avoid excessive administrative burdens. By mandating this disclosure, the bill aims to increase visibility into how health plans process and reject medical benefit requests.