As introduced: - Prohibits a health insurance issuer from using an automated process, including artificial intelligence, to downcode a medical claim. - Requires downcoding decisions to be made by a physician of the same or similar specialty as the treating physician after a documented review of clinical information. - Prohibits a health insurance issuer from downcoding a claim based solely on the reported diagnosis codes or in a manner that discriminates against physicians who treat patients with complex or chronic conditions. - Establishes notification requirements for issuers and an appeal process for physicians for any downcoded claims. - Exempts employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act.
| Date | Chamber | Action |
|---|---|---|
May 6, 2026 | S | Senate Floor Amendment No. 2 Referred to Assignments |
May 6, 2026 | S | Senate Floor Amendment No. 2 Filed with Secretary by Sen. David Koehler |
May 5, 2026 | H | Hearing Scheduled - Insurance Committee |
Apr 17, 2026 | S | Rule 2-10 Third Reading Deadline Established As May 8, 2026 |
Apr 14, 2026 | S | Hearing Scheduled - Insurance |
Apr 14, 2026 | S | Senate Floor Amendment No. 1 Recommend Do Adopt Insurance; 011-000-000 |
Apr 14, 2026 | S | Senate Floor Amendment No. 1 Assignments Refers to Insurance |
Apr 9, 2026 | S | Added as Co-Sponsor Sen. Lakesia Collins |
| Last Action | May 6, 2026 |
|---|---|
| Year | 2025 |
| Bill Type | Bill |
| Created | Mar 21, 2026 |
| Updated | May 7, 2026 |