Patient Refunds for Bad Denials Act of 2026

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 8442 Introduced in House (IH)] <DOC> 119th CONGRESS 2d Session H. R. 8442 To amend title XXVII of the Public Health Service Act to establish civil liability for health insurance issuers with high levels of claims denials. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES April 22, 2026 Ms. Craig (for herself and Mr. Ryan) introduced the following bill; which was referred to the Committee on Energy and Commerce _______________________________________________________________________ A BILL To amend title XXVII of the Public Health Service Act to establish civil liability for health insurance issuers with high levels of claims denials. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Patient Refunds for Bad Denials Act of 2026''. SEC. 2. ESTABLISHING CIVIL LIABILITY FOR HEALTH INSURANCE ISSUERS WITH HIGH LEVELS OF CLAIMS DENIALS. (a) In General.--Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended by adding at the end the following new part: ``PART F--CLAIMS DENIALS ``SEC. 2799C-1. CIVIL LIABILITY FOR HIGH RATES OF CLAIMS DENIALS. ``(a) In General.--The Secretary may impose on each health insurance issuer offering group or individual health insurance coverage for a plan year beginning on or after January 1, 2027, a civil monetary penalty not to exceed the amount specified in subsection (e) if the Secretary finds that any such coverage offered by such issuer during such plan year had an claims denial percentage of 25 percent (or such lower percent as the Secretary may specify) or greater. ``(b) Claims Denial Percentage.-- ``(1) In general.--For purposes of this section, the term `claims denial percentage' means, with respect to group or individual health insurance coverage and a plan y