Illinois House Bill 5918 was recently introduced, proposing regulatory oversight for health insurers’ use of artificial intelligence (AI).

The bill prohibits insurers from using AI or predictive models as the sole basis for denying, reducing, or terminating coverage or benefits. Adverse AI driven decisions must be reviewed by an authorized individual with the authority to override them.

The Department of Insurance would also be authorized to issue emergency rules to enforce these new regulations. The Department would be allowed to request information or documentation relevant to an investigation or market conduct action, and an insurer must comply with that request. The Department's inquiries may include, but are not limited to, questions regarding any specific model, AI system, or application of a model or AI system.

The Department may also make requests for information and documentation relating to AI systems governance, risk management, and use protocols; information and documentation relating to the insurer's pre-acquisition and pre-utilization diligence, monitoring, and auditing of data or AI systems developed by a third party; and information and documentation relating to implementation and compliance with the insurer's AI systems program.