S 1029

As introduced: - Requires health insurance payers to annually collect and publicly report data on health benefit claims, including denial rates, appeal outcomes, and rejection rates. - Imposes a penalty on payers that deny 20% or more of claims in a year without proper justification, requiring reimbursement to the covered person for the cost of the denied service. - Requires payers to disclose their use of automated utilization management systems, including those using artificial intelligence, and grants the Dept. of Banking and Insurance authority to audit these systems. - Mandates that every claim be reviewed by at least one medical director and that denial notices include information on the reviewing director's denial rate.