# 119-hr-8442: Patient Refunds for Bad Denials Act of 2026

119-hr-8442, Patient Refunds for Bad Denials Act of 2026, is a 119th Congress bill sponsored by Rep. Craig, Angie [D-MN-2] (D-MN); status introduced; PRIA reads it as touching household money (as of 2026-09-21).

- Canonical: https://policyrisk.com/legislation/119-hr-8442
- As of: 2026-09-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-8442
- Congress: 119
- Title: Patient Refunds for Bad Denials Act of 2026
- Status: introduced
- Introduced: 2026-04-22
- Sponsor: Rep. Craig, Angie [D-MN-2] (D-MN)
- Cosponsors: 1
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-09-21

## Summary

**Civil penalties for insurers with high claims denial rates** would be created, and insurers would have to give denied claimants the issuer’s medical necessity standards and a written explanation for denials. The bill targets plan years beginning on or after January 1, 2027 and lets the Secretary audit denial rates and set or lower the threshold as needed. - Families and patients could get money back when an issuer’s denial rate meets the threshold. Penalties collected would be distributed pro rata to enrollees for the affected plan year, and denied claimants must receive an explanation of the medical necessity standards used. - Health insurance issuers would face audits and a civil monetary penalty if their claims denial percentage is 25 percent or higher. Penalties would start at $10.0 million plus $2.0 million for each percentage point above 25 percent, with the Secretary able to account for issuer efforts to reduce denials. - The Secretary of Health and Human Services would audit plans to calculate denial rates, could exclude correctly denied fraud or nonmedical necessity claims from the denominator, could set a lower threshold, and may adjust penalty amounts for inflation starting in 2028.

## Cosponsors (1)

- Rep. Ryan, Patrick [D-NY-18] (D-NY), 2026-04-22T00:00:00.000Z

## Provisions PRIA read

- Fines for insurers, refunds to enrollees: mixed, low. If enacted, this bill would let HHS penalize health insurers that deny many claims. For plan years starting on or after January 1, 2027, an issuer with a claims denial percentage of 25% or more could face a base penalty of $10,000,000. The penalty would rise by $2,000,000 for each percentage point…

## Related bills

- 119-hr-10421: Transforming Education for the Future Act
- 119-hr-6900: American Affordability Act of 2025
- 119-hr-4669: FEMA Act of 2025
- 119-hr-7973: Momnibus Act
- 119-hr-7977: Energy Bills Relief Act
- 119-hr-3151: SHIPS for America Act of 2025

## Sources
- [119-hr-8442 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/8442)

## Related
- [119-hr-10421: Transforming Education for the Future Act](https://policyrisk.com/legislation/119-hr-10421)
- [119-hr-6900: American Affordability Act of 2025](https://policyrisk.com/legislation/119-hr-6900)
- [119-hr-4669: FEMA Act of 2025](https://policyrisk.com/legislation/119-hr-4669)
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-7977: Energy Bills Relief Act](https://policyrisk.com/legislation/119-hr-7977)
- [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-8442 (as of 2026-09-21).