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Hospital and Medical Services Utilization Review Act; requiring utilization review organization that uses AI to adhere to requirements; prohibiting AI from making certain determinations. Effective date.
In one paragraph
Oklahoma's SB 1967 (2026), as introduced, would have amended the Hospital and Medical Services Utilization Review Act to set conditions on AI tools used in utilization review by review organizations and insurers, including that the tool not supplant provider decision-making; per the official bill summary, the tool could not deny a claim based on medical necessity. It was referred to a Senate committee February 3, 2026 and died when the session ended May 14, 2026.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None: the bill died and never became law. It would have restricted insurers' and review organizations' use of AI in utilization review, with penalties (per the bill summary) of up to $500,000 for a health benefit plan.
Key provisions
- Would require a utilization review organization, disability insurer or specialized health insurer using an AI tool to ensure it bases determinations on the enrollee's medical history, individual clinical circumstances and other clinical information (Sec. 2(A))
- Would require that the tool not base determinations solely on a group dataset, not supplant health care provider decision-making, not discriminate in violation of law, and not use patient data beyond its stated purpose under HIPAA
- Per the bill summary, would prohibit the tool from denying a claim based on medical necessity and require documentation of its use
- Per the bill summary, would make the organization open to inspection for audit or compliance review by the Insurance Commissioner
- Per the bill summary, would set a maximum penalty of $500,000 for a health benefit plan and $100,000 for a clinical peer reviewer, with possible license suspension and an additional $10,000 fine per willful violation
- Referred to Senate Technology and Telecommunications February 3, 2026; died when the session ended May 14, 2026
Latest legislative action
Feb 3, 2026. Second Reading referred to Technology and Telecommunications; died when the Oklahoma Legislature's 2026 session ended May 14, 2026
Sponsors
| Name | Role |
|---|---|
| Mann | Primary |
| Osburn | Primary |
| Pugh | Primary |
Topics and industries
Related topics
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