As introduced: - Prohibits an artificial intelligence tool used by a health plan from denying, delaying, or modifying a determination on health care service coverage. - Requires any adverse coverage determination to be made only by a licensed health care provider competent to evaluate the specific clinical issues. - Establishes requirements for health plans using AI for utilization review, including that the tool must base its determination on an individual's specific clinical information and not solely on a group dataset. - Subjects a health plan's AI tool to audit by the Department of Financial Regulation and requires its performance and outcomes be reviewed at least quarterly.
| Date | Chamber | Action |
|---|---|---|
Jan 27, 2026 | H | Read first time and referred to the Committee on Health Care |
| Last Action | Jan 27, 2026 |
| Year | 2025 |
| Bill Type | Bill |
| Created | Jan 27, 2026 |
| Updated | Jan 28, 2026 |