In one paragraph
Nebraska's LB 77 (2025) adopts the Ensuring Transparency in Prior Authorization Act. Its AI section says an artificial intelligence-based algorithm may not be the sole basis for a utilization review agent's decision to deny, delay or modify health care services based on medical necessity. Agents must disclose to the Department of Insurance, to every network provider, to every enrollee and on their public website whether AI-based algorithms are or will be used in utilization review. The department may audit an agent's automated utilization management system at any time, including through a third party. The section is operative January 1, 2026.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
Health insurers and utilization review vendors in Nebraska need a human basis for medical-necessity denials and must publish whether they use AI in prior authorization.
Key provisions
- Sec. 12(1): an artificial intelligence-based algorithm shall not be the sole basis of a utilization review agent's decision to deny, delay, or modify health care services based in whole or in part on medical necessity
- Sec. 12(2): utilization review agents must disclose to the department, each network health care provider, each enrollee and on their public website whether AI-based algorithms are used or will be used in utilization review
- Sec. 12(3): the Department of Insurance may audit an agent's automated utilization management system at any time and may contract with a third party for the audit
- Sec. 17: sections 1-5 and 7-13 of the act, including the AI section, become operative January 1, 2026
Latest legislative action
Jun 4, 2025. Approved by Governor on June 4, 2025
Topics and industries
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