As artificial intelligence (AI) continues to be utilized across industries, a few states have recently introduced bills that would regulate how health insurers can use AI for their utilization review process.
California Senate Bill 1120 would require health care service plans or health care insurers to ensure that a licensed physician supervises the use of AI decision making tools used in utilization review for authorizing health care services.
Georgia House Bill 887 would prohibit the use of AI in making any decision concerning any healthcare coverage determination. Any such healthcare decision derived by an AI or an automated decision tool must be meaningfully reviewed by an individual with the authority to override the AI or automated decision tool.
New York Assembly Bill 9149 would require insurers authorized to write accident and health insurance or an HMO to notify insureds and enrollees about the use or lack of use of artificial intelligence algorithms in the utilization review process.
Oklahoma House Bill 3577 would require health insurers to disclose to providers and individuals whether AI is used in the insurer’s utilization review process. Insurer would also have to disclose information on their website and submit the algorithms and training data sets used to the Oklahoma Insurance Department.
Pennsylvania House Bill 1663 would require health insurers to disclose to providers and individuals whether AI is used in the insurer’s utilization review process. Insurer would also have to disclose on their website and submit the AI algorithms and training data sets to the Pennsylvania Department of Insurance.
