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Bill

JB

Bill

S 1029

Requires collection of data by health insurers regarding health insurance claims and decisions made using automated utilization management systems.

2026-2027 Regular Session Introduced by Jon Bramnick and 1 co-sponsor

New Jersey bill mandates insurers publicly report data on automated claim approval/denial decisions to increase transparency in utilization management systems.

Introduced in the Senate, Referred to Senate Commerce Committee
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Bill Summary · S 1029

Legislative bill overview

S 1029 requires health insurers operating in New Jersey to collect and report detailed data on their use of automated utilization management (UM) systems—the algorithms and software that insurers use to approve or deny coverage for medical services. The bill mandates transparency regarding how these automated systems make decisions about insurance claims, including approval rates, denial rates, and other performance metrics.

Why is this important

Automated UM systems significantly impact patient access to healthcare by determining which treatments get covered. Currently, insurers have limited transparency requirements around these systems, making it difficult for patients, providers, and regulators to identify potential biases, errors, or patterns of inappropriate denials. This data collection would provide visibility into whether these systems are functioning fairly and in patients' interests.

Potential points of contention

  • Insurer burden and costs: Health insurers may argue that mandated data collection imposes significant compliance costs and administrative burdens, potentially increasing insurance premiums.
  • Proprietary concerns: Insurers typically view their UM algorithms as proprietary business information and may resist detailed disclosures fearing competitive disadvantage or revealing trade secrets.
  • Regulatory scope: Questions about what specific data points must be collected, how granular the reporting should be, and whether data disaggregated by diagnosis or treatment type could inadvertently reveal proprietary decision-making logic.

Compiled from official sources — confirm details with the bill’s official record.

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