H.R. 9396 Prior Authorization Accountability Act: Disclosure Without Accuracy Verification
H.R. 9396 would require health plans to publish PA denial rates, appeal outcomes, and AI decision metrics starting 2027 — but contains no attestation, audit, or accuracy framework. Here's what compliance teams need to watch before rulemaking closes.
H.R. 9396, the Prior Authorization Accountability Act, would require health plans to disclose PA denial rates and AI decision metrics starting in 2027 — but includes no mechanism to verify that disclosed data is accurate. Compliance teams and legal counsel must act before rulemaking defines the standards.
H.R. 9396 was introduced June 23, 2026, and forwarded from the House Energy and Commerce Health Subcommittee to the full committee by voice vote on June 25, 2026. If enacted in its current form, the bill would apply to plan years beginning on or after January 1, 2027. The bill leaves timing, manner, aggregation, and some operational definitions to implementation by the relevant administering agencies — HHS for the PHSA provisions, Labor for ERISA, and Treasury for the IRC provisions. It does not specify how inaccurate disclosures would be detected or penalized.
Why this matters now: The rulemaking that follows enactment — if the bill advances — will determine whether accuracy of disclosed data is treated as an enforcement question or left unaddressed, as hospital price transparency illustrates: CMS lacked assurance on data completeness and accuracy until GAO recommended additional assessment.
What you need to know
- The proposed change: If enacted, health plans would be required to publicly disclose PA approval/denial rates, appeal outcomes, time-to-determination, and the percentage of decisions made solely through AI, machine-learning, decision-support, clinical decision-making, or other technology specified by the administering agency, beginning with plan years on or after January 1, 2027.
- Who would be affected: Commercial group health plans and individual health insurance issuers under PHSA, ERISA, and the IRC. Medicare Advantage is addressed under separate bills in the same markup package.
- Why it matters: The bill creates disclosure obligations but contains no accuracy-verification mechanism. A 2024 GAO report found that under the hospital price transparency regime, CMS checked required data fields but did not have assurance that the underlying data values were sufficiently complete and accurate — a gap that took nearly two years and a formal recommendation process to begin closing.
- What to do now: Plans using AI or automated tools in PA decisions should begin documenting decision rates and tool descriptions before 2027 plan year data starts accumulating. Legal counsel should monitor rulemaking for the denominator definition and any accuracy standard the administering agencies establish.
- Key date: January 1, 2027 — proposed effective date for plan year reporting obligations, if enacted.
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