POSITIVE Healthcare 118th Congress

H.R.3074 Due Process Continuity of Care Act

Reforms insurance prior authorization abuse — prevents insurers from delaying or denying necessary medical care (118th Congress)

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Legal & Constitutional Grounding

HHS OIG found MA plans denied care meeting Medicare rules; 80%+ of appealed denials overturned.

HHS OIG Report OEI-09-18-00260 (2022) — MA plans denied care meeting Medicare rules

AMA: 80.7% of MA appeal denials overturned
KFF: MA denial rates rose from 5.7% to 7.7% (2019-2024)

Reforms insurance prior authorization abuse to prevent delayed or denied medical care. Prior authorization denials delay treatment and cause documented patient harm, with insurers overturning 40-75% of denials on appeal.