In one paragraph
Maryland's HB 1385 (2026, first reader text) would have amended Insurance section 15-10B-05.1 so that audits and compliance reviews of AI, algorithms or software tools used by carriers for utilization review include a human evaluation of the patient's medical records by a licensed health care professional who can question, modify or override the tool's determination, and quarterly performance reviews include a human evaluation of real-world health outcomes. It had a House Health hearing set for March 12, 2026 and died when the 2026 session ended.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None: the bill died and did not become law. It would have required carriers using AI in utilization review to add licensed-professional review to audits and quarterly reviews.
Key provisions
- Would have amended Insurance section 15-10B-05.1, which covers carriers, pharmacy benefits managers and private review agents that use AI, algorithms or software tools for utilization review
- New subsection (E): Commissioner audits or compliance reviews must include a human evaluation of the patient's medical records by a licensed health care professional considering the patient's specific circumstances, who can question, modify or override the tool's determination
- New subsection (F): quarterly reviews of the tool's performance, use and outcomes must include a human evaluation of real-world health outcomes, used to improve the tool
- Existing duties kept: determinations may not rely solely on a group dataset, may not unfairly discriminate, may not replace the health care provider's role, and the tool may not directly or indirectly cause harm to an enrollee
- A tool may not deny, delay or modify health care services
- The bill adds no new penalty provisions; it would have taken effect October 1, 2026
Latest legislative action
Feb 13, 2026. Hearing 3/12 at 1:00 p.m.; died when the Maryland General Assembly's 2026 session ended April 13, 2026
Sponsors (showing 5 of 32)
| Name | Role |
|---|---|
| Anderson (By Request - Baltimore City Administration) | Primary |
| Baker | Primary |
| Feldmark | Primary |
| Frederick County Delegation | Primary |
| Hill | Primary |
Topics and industries
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Affected industries
This page is general information, not legal advice. Summaries are AI-assisted and may contain errors; read the statute for the controlling text and talk to a lawyer about your situation. Full disclaimer · Report an error