As AI continues to evolve and see greater utilization in healthcare, various state legislators have introduced bills to limit the decisions AI programs can make across care.
Alabama Senate Bill 63 would regulate currently unrestricted AI use in health benefit decision‑making by prohibiting insurers from relying exclusively on AI for coverage determinations and would require the decision to approve or deny coverage to always be made by a qualified healthcare professional.
Furthermore, this bill would require disclosure when AI is used and authorizes the Department of Insurance to take enforcement action for violations. If enacted, becomes effective October 1, 2026.
Additionally, Alabama House Bill 280 would establish an AI-assisted virtual health platform for rural communities under the Alabama Health Command. Along with required privacy standards, this bill would prevent AI from replacing licensed clinical work. If enacted, this bill would become effective October 1, 2026.
Hawaii House Bill 1787 would establish restrictions on the use of artificial intelligence, algorithms, or other software tools for purposes of decision-making in health insurance utilization reviews. Such decisions would require a licensed health care provider to review all adverse actions by the health carrier.
If enacted, this bill would take effect upon approval.
Kentucky House Bill 455 would restrict the use of artificial intelligence by certain licensed professionals in therapy and psychotherapy services. Among many stipulations, the bill would require clinician oversight for the use of AI, written consent for AI-assisted recorded sessions, and restrict AI from interacting directly with clients.
If enacted, this bill would take effect immediately upon enactment.
Oklahoma House Bill 3675 would prohibit AI-generated adverse determinations in health insurance utilization review, requiring human professional review. Furthermore, this bill would allow the Insurance Commissioner to audit automated systems for such systems.
If enacted, this bill would go into effect on November 1, 2026.
Pennsylvania Senate Bill 1113 would establish comprehensive AI oversight across facilities, insurers, and Medicaid/CHIP plans in clinical decision-making. The bill would require AI disclosures in decision making, responsible use standards, recordkeeping, and penalties. If enacted, this bill would go into effect one year after becoming law.
Virginia Senate Bill 586 would require health carriers to disclose how AI is used to manage claims coverage and to submit all information enabling decisions made by artificial intelligence to the State Corporation Commission upon request. Furthermore, the bill prohibits exclusive AI reliance for adverse determinations, mandates expedited external review, and enables civil penalties up to $50,000 and potential license suspension. If enacted, this bill would go into effect July 1st following the adjournment of the session.
