In one paragraph
Not law. S. 920 would have required South Carolina health insurers that use AI, algorithms or other software for prior authorization to base decisions on the patient's own medical history and clinical circumstances, have a licensed physician or other qualified professional make every denial, reduction or deferral, tell enrollees that AI is used, certify yearly that their tools are fair and non-discriminatory, and share denial rates on request, with Department of Insurance enforcement. The Senate Banking and Insurance Committee reported it favorably on April 30, 2026, but it was never taken up before the regular session ended.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None: the bill did not pass, so it creates no obligations for South Carolina health insurers.
Key provisions
- Would have added Article 25 to Chapter 71, Title 38: prior authorization determinations made with AI
- Determinations based on the enrollee's medical history, clinical circumstances and medical record, not solely on group datasets
- Every denial, reduction or deferral made by a licensed physician or other competent health care professional
- Prominent disclosure to enrollees that AI, algorithms or software are used in utilization review
- Annual certification to the Department of Insurance of fairness, non-discrimination and periodic review; denial percentages available on request
- Department of Insurance enforcement: notice, hearing, corrective plans and, for repeat violations, discipline under Section 38-71-90
- Introduced February 11, 2026; reported favorably April 30, 2026; no floor action before the session ended
Latest legislative action
May 6, 2026. Reported favorably by Senate Banking and Insurance; not taken up before the 2026 regular session ended, and the sine die resolution (S. 883) does not allow it
Sponsors
| Name | Role |
|---|---|
| Blackmon | Primary |
| Devine | Primary |
| Leber | 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