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HR8377119th CongressWALLET
Stop Deadly Denials Act of 2026
Sponsored By: Representative Khanna, Ro [D-CA-17]
Introduced
Summary
Ends most prior authorization in Medicare Advantage and blocks AI-only denials in traditional Medicare. This bill would bar Medicare Advantage plans from requiring prior authorization for most specified items and services in plan years beginning January 1, 2027, add enforcement penalties for violations, and prevent CMS from testing prior-authorization models like WISeR without physician oversight.
Show full summary
- Medicare Advantage enrollees and families would face fewer administrative prior-authorization hurdles for non-Part D and non-supplemental benefits, aiming to reduce delays and denials.
- Medicare Advantage plans and providers would be subject to new intermediate sanctions if they impose banned prior-authorizations, and statutory language about prior authorization would be revised to emphasize review and transitional rules through 2027.
- CMS and the Innovation Center would be barred from implementing the WISeR model or any substantially similar program and from selecting models that add prior authorization for Part A or B. Models could not deny coverage based solely on AI or algorithmic decisions without physician review and must be processed by Medicare Administrative Contractors.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
No prior authorization in Medicare Advantage
This bill would bar Medicare Advantage plans from requiring prior authorization for most items and services in plan years that begin on or after January 1, 2027. The ban would not apply to covered Part D drugs or to supplemental health care benefits. It also would not change prior authorization rules that are already required under Part A or Part B statutes. Regulators would be able to use intermediate enforcement sanctions against plans that impose banned prior authorization requirements, and that enforcement change would take effect on enactment.
Limits on Medicare prior authorization models
The bill would stop HHS from implementing the WISeR prior-authorization model described in the July 1, 2025 notice. It would also bar the agency from selecting any new testing model that would add prior authorization for Part A or Part B services. The bill would forbid denials based only on AI or similar algorithms unless each denial is individually reviewed and approved by a physician, and it would require prior-authorization work to be done by a Medicare Administrative Contractor. Starting January 1, 2027, the Secretary would need to give public notice and a chance for comment before selecting certain models.
Sponsors & CoSponsors
Sponsor
Khanna, Ro [D-CA-17]
CA • D
Cosponsors
Rep. Jayapal, Pramila [D-WA-7]
WA • D
Sponsored 4/20/2026
Rep. Cohen, Steve [D-TN-9]
TN • D
Sponsored 4/20/2026
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 4/20/2026
Rep. Jackson, Jonathan L. [D-IL-1]
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.
View on Congress.gov