HB 1787

As introduced: - Requires that algorithms used for utilization review are based on an individual patient’s medical history and clinical circumstances, not just group data. Requires algorithms be open to inspection by the commissioner. - Requires health carriers to provide written disclosure in each health plan on how artificial intelligence is used in the utilization review process. - Prohibits health carriers and utilization review organizations from using artificial intelligence, algorithms, or other software tools to deny, delay, or modify a determination to provide health care services. - Requires a licensed health care provider to conduct an independent review of a claim before a health carrier may issue an adverse action, including the denial of a prior authorization.