Stop Deadly Denials Act of 2026
Sponsored By: Representative Khanna
Introduced
Summary
End most prior authorization in Medicare Advantage. This bill would bar Medicare Advantage plans from imposing prior authorization for most items and services starting with plan years beginning January 1, 2027, and would limit CMS from testing or using similar prior-authorization models in traditional Medicare.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Ban on prior authorization in Medicare Advantage
This bill would prohibit Medicare Advantage plans from requiring prior authorization for most items and services starting with plan years that begin on January 1, 2027. "Specified item or service" would mean any benefit the MA plan covers that is not a covered Part D drug or a supplemental health care benefit. The ban would not apply in a plan year if that item or service is already subject to prior authorization under certain Part A or Part B statutory provisions. Plans that impose prior authorization in violation of this rule would be subject to intermediate sanctions by HHS/CMS.
Limits on AI-driven Medicare models
This bill would stop CMS from selecting demonstration models that implement prior authorization for Medicare Part A or B items if the model would deny coverage or payment based only on AI, machine learning, or similar automated logic without physician review using independent medical judgment. It would also bar models that let entities other than Medicare administrative contractors process prior authorization requests. The bill would prohibit implementing the WISeR model described in the July 1, 2025 Federal Register or any substantially similar model. For models chosen on or after January 1, 2027, the bill would require notice and an opportunity for public comment before selection.
Sponsors & CoSponsors
Sponsor
Khanna
CA • D
Cosponsors
Rep. Jayapal, Pramila [D-WA-7]
WA • D
Sponsored 4/20/2026
Cohen
TN • D
Sponsored 4/20/2026
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 4/20/2026
Jackson (IL)
IL • D
Sponsored 4/20/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 4/20/2026
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 4/20/2026
Roll Call Votes
No roll call votes available for this bill.
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