After several states introduced bills throughout January to regulate the use of AI to make healthcare and insurance decisions, more states have continued to introduce similar bills in February.

Colorado House Bill 1139 would permit health insurers, PBMs, and other entities to use AI in utilization review but would prohibit decisions based solely on group data and requires that any denial or delay of coverage be reviewed by a licensed clinician, with determinations based on an individual patient’s clinical circumstances.  Additionally, the bill would set regulations around mental health chatbots, along with requirements for professionals to disclose when AI systems are used in practice and what purpose they serve.

Georgia Senate Bill 444 would prohibit insurance coverage decisions from being made solely by AI systems, or other software tools.

Iowa Senate Study Bill 3118 would allow utilization review organizations to use AI algorithms for initial prior authorization reviews, but would prohibit AI from being used as the sole basis for denying, delaying, or downgrading requests for services based on medical necessity.

Illinois Senate Bill 2993 would prevent licensed providers from allowing AI to prescribe medication if the person licensed under the Medical Practice Act does not maintain full control and responsibility for the prescription. Additionally, the bill would establish penalty provisions for violations of provisions concerning the use of artificial intelligence to prescribe medication.

Meanwhile, Illinois House Bill 4804 would add provisions governing AI in recorded or transcribed patient encounters. This bill would prohibit substituting AI for nursing services, and would require healthcare entities deploying AI in direct patient care to maintain validation and bias monitoring records available to regulators.

Rhode Island S 2010 would require insurers to disclose how they use AI to manage healthcare claims and coverage, including but not limited to:

• The types of artificial intelligence models used
• The role of artificial intelligence in the decision-making process,
• Training datasets
• Performance metrics
• Governance and risk management policies
• The decisions on healthcare claims and coverage where artificial intelligence made, or was a substantial factor in making, decisions