H.R.8442

Patient Refunds for Bad Denials Act of 2026 establishes penalties for high claims denial rates by health insurers.

The Patient Refunds for Bad Denials Act of 2026 amends the Public Health Service Act to establish civil liability for health insurance issuers with high claims denial rates. The Secretary can impose a civil monetary penalty on issuers with a claims denial percentage of 25% or higher, with additional penalties for higher denial rates. The Secretary can also conduct audits to ascertain claims denial percentages. The bill mandates that insurers provide notice to individuals when claims are denied, including medical necessity standards and explanations for denials.