Protecting Patients from Automated Denials Act
To amend title XVIII of the Social Security Act to establish requirements for the use of artificial intelligence in prior authorization denials by Medicare Advantage organizations.
This bill proposes to change how Medicare Advantage organizations use artificial intelligence (AI) when deciding whether to approve certain medical treatments. It would set specific rules for when and how AI can be used in the process of denying prior authorization for these treatments. The bill aims to ensure that decisions are fair and transparent, protecting patients' rights.
This change would mainly affect people who have Medicare Advantage plans, which are private health plans offered by companies approved by Medicare. These plans must follow the rules set by Medicare. The bill hopes to improve the fairness and accuracy of AI-driven decisions in healthcare, ultimately benefiting patients by ensuring they get the treatments they need.
As of the last update on July 16, 2026, the bill was introduced in the House and referred to the Committee on Ways and Means and the Committee on Energy and Commerce. This means it is currently being reviewed and discussed by relevant committees. The bill is in the early stages of the legislative process, and further action is needed to move it forward.
