What does Preamble of Prior Authorization Accountability Act do?

This bill, formally titled 'To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates,' aims to modify several existing federal laws. The bill proposes amendments to title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986.

What does SHORT TITLE. of Prior Authorization Accountability Act do?

This bill is formally titled the Prior Authorization Accountability Act.

What does DISPLAYING CLAIM DENIAL RATES. of Prior Authorization Accountability Act do?

This section amends the Public Health Service Act and the Employee Retirement Income Security Act of 1974 to establish prior authorization transparency requirements. Group health plans and health insurance issuers offering group or individual health insurance coverage that impose prior authorization requirements must submit data to the Secretary and make it publicly available. The required information includes a list of items and services subject to prior authorization, approval and denial rates, appeal outcomes, processing times, and the use of technology in decision-making. Plans and issuers must publish this information at the plan or coverage level, and potentially in the aggregate, as specified by the Secretary. These requirements apply to plan years beginning on or after January 1, 2027.

What does PROMOTING COMPARABILITY OF QUALIFIED HEALTH PLANS OFFERED of Prior Authorization Accountability Act do?

This section amends section 1311(d)(4)(C) of the Patient Protection and Affordable Care Act. The amendment modifies language related to websites used for qualified health plan comparisons. It requires websites to include comparative information for enrollments beginning on or after January 1, 2029. For qualified health plans offered through an Exchange that were also offered in a previous plan year, the websites must include the most recent information submitted to the Exchange by the health insurance issuer under section 2799A-12 of the Public Health Service Act.

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Prior Authorization Accountability Act

Last updated: 6/25/2026 · Introduced: 6/23/2026

Author: Craig Goldman (R-TX)

TL;DR (AI)

The bill mandates that group health plans and health insurance issuers publicly disclose data on prior authorization requirements, including approval and denial rates, starting in 2027.
It requires websites used for comparing health plans to include comparative information for plans offered through an Exchange, beginning in 2029.
The bill amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to implement these transparency measures.

119th Congressin committeeOfficial page

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Other Sections

Includes provisions on preamble, short title., and 2 more.

4 sections

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