Stop Deadly Denials Act of 2026

This legislation, titled the "Stop Deadly Denials Act of 2026," seeks to curtail the use of prior authorization across Medicare. A primary provision **prohibits Medicare Advantage plans** from requiring prior authorization for most specified items and services for plan years beginning on or after January 1, 2027. This prohibition includes an exception for services already subject to prior authorization under traditional Medicare Part A or B, and it excludes Part D drugs and supplemental health benefits. Non-compliant plans would face **intermediate sanctions**.

The bill also addresses prior authorization in **traditional Medicare** by preventing the implementation of the "Wasteful and Inappropriate Services Reduction (WISeR) Model" or any similar model. Furthermore, it limits future **Center for Medicare and Medicaid Innovation (CMI) models** that test prior authorization. Such models would be restricted if they involve **AI-driven denials without individual physician review** and approval, or if prior authorization requests are processed by entities other than Medicare administrative contractors. All future CMI models will also require **public notice and comment** before selection.