Maine LD955 prohibits health insurance carriers from denying claims solely based on artificial intelligence starting January 1, 2026.
Maine LD955 mandates that health insurance carriers cannot deny coverage or claims for services under a health plan solely based on artificial intelligence starting January 1, 2026. Before a carrier denies benefits or reduces payment for services using artificial intelligence, a licensed physician must conduct a utilization review. This review must include an assessment of the medical necessity of the services, the professional judgment of the enrollee's provider, and the impact of any denial of benefits or reduction in payment on the enrollee's health outcomes.
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