Allergy & Asthma Patient Protection Act of 2026

What it does

• •Requires group health plans and health insurance issuers to cover allergy and asthma diagnostic testing (including skin testing, intradermal testing, patch testing, and spirometry) without limits on the number of allergens tested, prior authorization requirements inconsistent with clinical standards, or denial based on documentation or testing method combinations.
• •Requires coverage of allergen immunotherapy (immune tolerance building treatments) with specific protections including coverage for extract preparation regardless of diluent presence or vial count, all medically necessary therapy components, and prohibits medically unlikely edit limits, volume-based caps, and single date-of-service requirements.
• •Establishes that coverage determinations must align with 'recognized clinical standards' as defined by clinical practice parameters published by national allergy/asthma medical specialty organizations.

Why it matters

• •Removes existing insurance barriers to allergy and asthma diagnosis and treatment by prohibiting utilization management tools (prior authorization, step therapy, medically unlikely edits) that may delay or restrict care.
• •Standardizes coverage across private insurance types (group and individual plans) based on clinical evidence from specialty medical organizations rather than insurance company cost-containment policies.

Who is affected

• •Patients with allergies or asthma seeking diagnostic testing and immunotherapy treatment covered by group health plans or individual health insurance policies.
• •Health insurance issuers offering group or individual coverage and group health plans, which must modify coverage policies and reimbursement practices.

What happens next

The bill was referred to the Committee on Energy and Commerce as of November 12, 2026; the requirements would take effect for plan years beginning on or after January 1, 2028, if enacted.