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AI Summary
The bill mandates licensed provider reviews of specific adverse actions in health insurance utilization reviews involving AI, with guidelines on AI use.
Business Impact
If you operate in health insurance, you must ensure licensed provider reviews of AI-driven adverse actions by January 1, 2025, or face penalties.
What do these statuses mean? ▼
Introduced
— Filed in the legislature; not yet heard in committee
In Committee
— Assigned to and being reviewed by a legislative committee
Passed
— Approved by one or both chambers; awaiting further action
Signed / Enacted
— Signed into law by the governor; may or may not be in effect yet
Dead / Vetoed
— Vetoed, failed to pass, or session expired without action
Unknown
— Status data not yet available or awaiting classification
Affected Industries
Topics How we classify →
What This Means
H.B. No. 1787 aims to enhance accountability in health insurance utilization reviews by requiring that specific adverse actions involving AI and similar technologies undergo review by a licensed health care provider.
Key Provisions
- Regulates AI in health insurance utilization reviews, ensuring human oversight for specific adverse actions.
- Requires licensed health care provider review of specific adverse actions within health insurance utilization reviews involving AI, algorithms, or other software tools, including denials or reductions in coverage.
- Includes specific restrictions on the use of AI, algorithms, or software tools in health insurance utilization reviews.
Latest Legislative Action
Referred to HLT, ECD, CPC, referral sheet 1
Bill Sponsors (showing 5 of 32)
| Name | Role |
|---|---|
| AMATO | Primary |
| BELATTI | Primary |
| GANADEN | Primary |
| GARCIA | Primary |
| GARRETT | Primary |
Compliance Checklist
Ensure AI tools comply with specified determination criteria.
Who: Health carriers and utilization review organizations.
Deadline: Upon enactment of the bill.
Penalty: Potential fines or sanctions from the insurance commissioner.
Who: Health carriers and utilization review organizations.
Deadline: Upon enactment of the bill.
Penalty: Potential fines or sanctions from the insurance commissioner.
Conduct independent reviews of adverse actions by licensed health care providers.
Who: Health carriers.
Deadline: Before issuing any adverse action.
Penalty: Invalidation of adverse actions and potential regulatory penalties.
Who: Health carriers.
Deadline: Before issuing any adverse action.
Penalty: Invalidation of adverse actions and potential regulatory penalties.
Related & Companion Bills
Full Legal Analysis
H.B. No. 1787 introduces specific requirements for health carriers and utilization review organizations that employ artificial intelligence, algorithms, or other software tools in their decision-making processes. The bill requires that specific adverse actions within the context of health insurance utilization reviews involving these technologies, such as denials or reductions in coverage, be reviewed by a licensed health care provider. It ensures that these decisions are not solely based on algorithmic outputs without human oversight, and includes specific restrictions on the use of AI, algorithms, or software tools.
Official Source
Official Bill Text
View HB1787 on official legislature website →
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