Bill · H.R. 8442· House(119-HR-8442)
Patient Refunds for Bad Denials Act of 2026
- Introduced
- 4/22/2026
- Last activity
- 4/22/2026 — Referred to the House Committee on Energy and Commerce.
- Sponsored by
- Angie Craig
- Cosponsors
- - 1 - 0
- Introduced
- In Committee
What this bill would do
The Patient Refunds for Bad Denials Act of 2026 seeks to amend the Public Health Service Act to hold health insurance issuers accountable for high rates of denied claims. If an issuer's claims denial percentage reaches 25 percent or higher, the Secretary may impose a significant civil monetary penalty. These collected penalties are to be distributed to the individuals enrolled in those specific insurance plans. Additionally, the bill requires issuers to provide specific transparency regarding denied claims based on medical necessity. The Act also mandates that insurers report their annual claims denial rates to the Secretary.
Yes· 3 of 8
Does this give people more protection from unfair business practices?+7
The bill increases accountability for insurance issuers by penalizing high rates of denied claims and requiring transparency.
Does this strengthen the Affordable Care Act?+5
The bill strengthens consumer protections within the health insurance market regulated under the Public Health Service Act.
Does this make what the government does easier for the public to see?+5
The bill mandates that insurance issuers report annual claims denial rates to the Secretary.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Financial Relief through Penalty Redistribution: The Secretary will distribute collected civil penalties to individuals enrolled in the affected insurance plans on a pro rata basis (Section 2, subsection a, part F, SEC. 2799C-1 (d)).
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Increased Transparency for Denied Claims: If a claim is denied because it was not deemed medically necessary, the issuer must provide the individual with their medical necessity standards and an explanation of why the service failed to meet them (Section 2, subsection b, SEC. 2730 (a)).
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Accountability for High Denial Rates: The bill allows the Secretary to penalize issuers with a claims denial percentage of 25 percent or greater, which could serve to reduce high rates of denials (Section 2, subsection a, part F, SEC. 2799C-1 (a)).
Potential Negative Impacts for People
- Burden of Proof on Fraud Claims: When an issuer claims a denial was due to fraud, they must provide sufficient information to the Secretary to demonstrate the claim was indeed fraudulent to avoid it being counted against their denial percentage (Section 2, subsection a, part F, SEC. 2799C-1 (b)(3)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Healthcare
- Increases Affordable Care Act Support+5Improves Healthcare Access+4
- Demographic And Interest Groups
- Good For Low Income Households+3Good For Middle Class Households+3Good For Urban Residents+2
- Economy And Finance
- Improves Consumer Protection+7
- Governance And Ideology
- Improves Government Transparency+5
- Social Issues And Justice
- Improves Poverty Reduction+2
- 4/22/2026
- Referred to the House Committee on Energy and Commerce.
- 1 Cosponsor added.
- Introduced in House
Patrick RyanDemocrat · New York