PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Hinson, Ashley [R-IA-2] · R–IA
Legislative record
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Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Aug 14, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-08-03 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed Health Insurance Transparency for Patients Act would require insurers offering group or individual coverage and Medicare Advantage organizations to publish yearly information about coverage decisions. Patients could see counts and percentages of approvals, denials, appeals, and overturned denials. The bill would also require public lists of covered services and items that need advance approval, commonly called prior authorization.
This Act may be cited as the Health Insurance Transparency for Patients Act.
A health insurance issuer offering group or individual health insurance coverage for a plan year shall, not later than 1 year after the last day of each such plan year, submit to the Secretary and make publicly available on a website of the issuer
a contract under this section with an MA organization shall require such organization, not later than 1 year after the last day of each such plan year, to submit to the Secretary and make publicly available on a website of such organization
the percentage and number of each of the following: (1) Coverage requests denied, in whole or in part, by the issuer on initial review. (2) Coverage requests approved by the issuer on initial review. (3) Appeals of coverage requests denied by the issuer and any such appeals that resulted in reversal, in whole or in part, of such denials.
a list of all covered items or services that are subject to prior authorization.
Insurers offering group or individual health insurance would have to submit each plan year's information to the Secretary of Health and Human Services and publish it on their own websites within one year after that plan year ends. The statistics would have to be deidentified—without identifying patients—and presented simply and understandably.
A health insurance issuer offering group or individual health insurance coverage for a plan year shall, not later than 1 year after the last day of each such plan year, submit to the Secretary and make publicly available on a website of the issuer, with respect to such plan year— (1) the deidentified information described in subsection (b), disaggregated in accordance with subsection (c), in a consumer-friendly manner that is simple and understandable
Medicare Advantage organizations would face the same one-year reporting deadline through their contracts. They would have to submit and publish deidentified, understandable information for each Medicare Advantage plan they offered during the reporting year.
a contract under this section with an MA organization shall require such organization, not later than 1 year after the last day of each such plan year, to submit to the Secretary and make publicly available on a website of such organization, with respect to each MA plan offered by such organization during such plan year— (i) the deidentified information described in subparagraph (B), disaggregated in accordance with subparagraph (C), in a consumer-friendly manner that is simple and understandable
Both reporting systems would cover claims and requests for advance approval. A covered item or service would mean something for which benefits are available under the relevant insurance coverage or Medicare Advantage plan.
The term coverage request means— (A) a claim for a covered item or service; and (B) a prior authorization request for a covered item or service.
The term covered item or service means, with respect to a health insurance issuer offering group or individual health insurance coverage, an item or service for which benefits are available under such coverage.
The term coverage request means— (I) a claim for a covered item or service; and (II) a prior authorization request for a covered item or service.
The term covered item or service means, with respect to an MA plan, an item or service for which benefits are available under such plan.
Insurers and Medicare Advantage organizations would report both counts and percentages of initial approvals, initial denials in whole or in part, appeals of denials, and appeals that overturned a denial in whole or in part.
the percentage and number of each of the following: (1) Coverage requests denied, in whole or in part, by the issuer on initial review. (2) Coverage requests approved by the issuer on initial review. (3) Appeals of coverage requests denied by the issuer and any such appeals that resulted in reversal, in whole or in part, of such denials.
the percentage and number of each of the following: (i) Coverage requests denied, in whole or in part, by the MA organization on initial review. (ii) Coverage requests approved by the MA organization on initial review. (iii) Appeals of coverage requests denied by the MA organization and any such appeals that resulted in reversal, in whole or in part, of such denials.
The statistics would have to be broken down by request type, reason for denial, and type of covered item or service. They would also distinguish denials reached through fully automated review, including artificial intelligence, algorithmic review, or review by a person.
shall be disaggregated by— (1) the type of coverage request; (2) the reason for the denial; (3) the process by which denied coverage requests were reviewed, including whether the denial determination was the result of a fully automated review process (such as artificial intelligence), an algorithmic review, or review by an individual; (4) the type of covered item or service
shall be disaggregated by— (i) the type of coverage request; (ii) the reason for the denial; (iii) the process by which denied coverage requests were reviewed, including whether the denial determination was the result of a fully automated review process (such as artificial intelligence), an algorithmic review, or review by an individual; (iv) the type of covered item or service
Both reporting systems would also break down the information by the time from filing a request or appeal to the decision, expressed in days and hours. Appeal reporting would distinguish appeals handled on an expedited, or faster, basis.
(5) the time that elapsed between when the coverage request or the appeal of a denial of a coverage request (as applicable) was filed and when the health insurance issuer offering group or individual health insurance coverage reached a determination as to such coverage request or appeal, expressed in days and hours; and (6) in the case of an appeal of a denial of a coverage request, whether such appeal was expedited.
(v) the time that elapsed between when the coverage request or the appeal of a denial of a coverage request (as applicable) was filed and when the MA organization reached a determination as to such coverage request or appeal, expressed in days and hours; and (vi) in the case of an appeal of a denial of a coverage request, whether such appeal was expedited.
Alongside the statistics, insurers and Medicare Advantage organizations would have to submit and publish lists of all covered items or services requiring prior authorization.
(2) a list of all covered items or services that are subject to prior authorization.
(ii) a list of all covered items or services that are subject to prior authorization.
The Secretary would establish standard definitions and reporting formats intended to make the statistics accurate, comparable, and understandable. To the greatest extent practicable, those standards would avoid requiring insurers or Medicare Advantage organizations to obtain additional information from health care providers.
The Secretary shall establish standard definitions and reporting formats for the information described in subsection (b) to— (1) ensure that such information is accurate, easy to compare, and consumer-friendly; and (2) to the greatest extent practicable, ensure that the submission of such information does not require a health insurance issuer offering group or individual health insurance coverage to seek additional information from a health care provider.
The Secretary shall establish standard definitions and reporting formats for the information described in subparagraph (B) to— (i) ensure that such information is accurate, easy to compare, and consumer-friendly; and (ii) to the greatest extent practicable, ensure that the submission of such information does not require an MA organization to seek additional information from a health care provider.
The Secretary would also have to publish the submitted information annually on the Department of Health and Human Services website.
On an annual basis, the Secretary shall make available on the website of the Department of Health and Human Services the information submitted to the Secretary under subsection (a).
On an annual basis, the Secretary shall make available on the website of the Department of Health and Human Services the information submitted to the Secretary under subparagraph (A).
Both sets of requirements would begin with plan years starting on or after January 1 of the first year after enactment. The first reporting deadlines would then depend on when those plan years end.
The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1 of the first year beginning after the date of enactment of this subsection.
For plan years beginning on or after January 1 of the first year beginning after the date of enactment of this paragraph
not later than 1 year after the last day of each such plan year
The supplied actions snapshot, updated August 14, 2026, records introduction in the House on August 3, 2026, and referral that day to the Energy and Commerce and Ways and Means committees for provisions within their respective jurisdictions.
Source snapshot updated 2026-08-14T08:05:44Z.
2026-08-03: Introduced in House
2026-08-03: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
A closer look
Reviewed version: Introduced in House · 2026-08-03. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. Formal earmark status in other versions or accompanying materials cannot be established from this bundle.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption, or preferential treatment was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence elsewhere.
Full text preserved for this analysis. Legislative record snapshot: Aug 14, 2026. How PlainBill uses AI