Stop health insurers from using computers to slash payouts

Insurance; claims processing; downcoded claims

Introduced· 2026-01-22

Who's it for

Who's it for: Healthcare Providers

What it means for you

9/10Helps you

Good for everyday people ·

Plain‑English summary, cross‑checked against the official bill text.

This bill stops health insurance companies from using computer programs to automatically lower the amount they pay your doctor for your medical care.

Our take

What we think, in plain words.

Health insurance companies often use computer programs to automatically downgrade medical claims so they can pay less than what the doctor billed. When insurers do this, doctors lose money and might even pass the extra cost on to you. This bill forces insurers to have a real human doctor review the claim before they can cut the payout. It also gives your doctor a fair chance to fight back if the insurer refuses to pay the full amount.

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The facts

What the bill actually says, no spin.

Bans health insurers from using automatic computer tools to make final decisions on lowering a medical bill.
Forces a real doctor with the same specialty to review the medical records before the insurer can pay less.
Requires insurers to give a specific reason and the name of the person who decided to lower the payment.
Gives doctors at least 180 days to appeal the decision.
Fines insurers up to $100 per violation and forces them to reprocess unfair claims with interest.