Tennessee HB1866 amends health insurance regulations to ensure medical necessity decisions are made by licensed professionals, not AI.
Tennessee HB1866 modifies health insurance regulations to prohibit the denial, delay, or modification of healthcare services based on medical necessity unless reviewed by a licensed healthcare professional. The bill mandates that any use of artificial intelligence, algorithms, or software tools for utilization review or management must be overseen by a licensed professional. It also allows aggrieved individuals to bring private lawsuits against health insurance issuers for violations, seeking actual damages, punitive damages, and reasonable court costs and attorney fees.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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