Regulates use of artificial intelligence in health insurance decisions and requires independent reviews of adverse actions.

The bill aims to regulate the use of artificial intelligence, algorithms, and software tools in health insurance utilization reviews. It mandates that health carriers and utilization review organizations using such tools must ensure they base decisions on relevant clinical information, not solely on group datasets. Additionally, the bill requires a licensed health care provider to review adverse actions before they can be taken. It also mandates that these tools be configured consistently, open to audits, and subject to quarterly reviews for accuracy and reliability.

Regulates use of artificial intelligence in health insurance decisions and requires independent reviews of adverse actions.

The bill aims to regulate the use of artificial intelligence, algorithms, and software tools in health insurance utilization reviews. It mandates that health carriers and utilization review organizations using such tools must ensure they base decisions on relevant clinical information, not solely on group datasets. Additionally, the bill requires a licensed health care provider to review adverse actions before they can be taken. It also mandates that these tools be configured consistently, open to audits, and subject to quarterly reviews for accuracy and reliability.