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AN ACT RELATING TO INSURANCE -- THE TRANSPARENCY AND ACCOUNTABILITY IN ARTIFICIAL INTELLIGENCE USE BY HEALTH INSURERS TO MANAGE COVERAGE AND CLAIMS ACT
In one paragraph
Rhode Island's proposed Transparency and Accountability in AI Use by Health Insurers to Manage Coverage and Claims Act. Health insurers, and contractors acting for them, would have to disclose to the health insurance commissioner and DBR how they use AI in claims and coverage decisions (models, role, training data, performance metrics, governance) and keep records of AI-driven decisions for five years. Any clinical denial in which AI was a substantial factor would need review and approval by a provider with the same license as the ordering provider, or it would be invalid. Regulators would report yearly. The Senate passed a substitute on June 9, 2026.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
If enacted, health insurers in Rhode Island would need AI disclosures to regulators, five-year records and same-license clinician sign-off on AI-driven clinical denials.
Key provisions
- Would create R.I. Gen. Laws chapter 27-84; covers insurers and any agent or contractor administering or reviewing claims
- Disclosure to OHIC and DBR of AI models, their role in decisions, training datasets, performance metrics and governance
- Records of AI decisions, including adverse determinations where AI was a substantial factor, kept at least five years
- Non-administrative (clinical) denials where AI made or substantially drove the decision must be reviewed and approved by a provider with the same license status as the ordering provider, with documented rationale
- Determinations that skip that review are invalid and must be reconsidered; appeals follow chapter 27-18.9
- OHIC and DBR report to the Governor and legislative leaders within 18 months and yearly: models used, claim and denial rates, review times, appeals and reversals
- Would take effect on passage; the Senate passed Substitute A on June 9, 2026
Latest legislative action
Jun 9, 2026. 06/09/2026 Senate passed Sub A
Sponsors (showing 5 of 11)
| Name | Role |
|---|---|
| Burke | Primary |
| Ciccone | Primary |
| DiMario | Primary |
| DiPalma | Primary |
| Gu | 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