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Relates to the use of artificial intelligence by insurers and clinical peer reviewers for utilization review; establishes additional notice requirements for adverse determinations.
The bill addresses AI use in utilization reviews, but specific details about notifications and algorithm criteria require verification from the full bill text.
If you are an insurer using AI for utilization reviews, you must notify stakeholders and disclose algorithm details or face fines up to $10,000 per violation.
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Affected Industries
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What This Means
This bill addresses the use of artificial intelligence in the insurance sector, particularly regarding utilization reviews. Verification from the full bill text is needed for specific claims.
Key Provisions
- Verification from the full bill text is needed for claims about AI algorithm notifications.
- Assertions about adverse determinations and clinical peer reviewers require confirmation from the bill text.
- Claims about algorithm criteria and quality assurance testing results need verification from the bill text.
Latest Legislative Action
referred to insurance
Bill Sponsors
| Name | Role | District |
|---|---|---|
| David Weprin D | Sponsor | HD-024 |
Compliance Checklist
Who: Insurers
Deadline: Upon first adoption and once per policy period
Penalty: Fines up to $10,000 per violation
Who: Insurers
Deadline: As specified by the superintendent
Penalty: License suspension or fines
Related & Companion Bills
Full Legal Analysis
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