In one paragraph
Texas HB 2922 (2025), as introduced, would have barred a utilization review agent from using an artificial intelligence-based algorithm as the sole basis for a decision to wholly or partly deny, delay, or modify health care services for an enrollee on medical necessity grounds. Only a physician or licensed health care provider could determine medical necessity, and the insurance commissioner could audit and inspect the agent's use of AI at any time. It did not pass both chambers and died when the session adjourned June 2, 2025.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
No duties for businesses because the bill died. Had it passed, health plans' utilization review agents would have had to keep a human clinician as the decision-maker on medical necessity denials and delays.
Key provisions
- A utilization review agent may not use an AI-based algorithm as the sole basis of a decision to wholly or partly deny, delay, or modify health care services for an enrollee on the basis of medical necessity or appropriateness
- Only a physician or licensed health care provider acting in accordance with the chapter may determine medical necessity or appropriateness
- The commissioner may audit and inspect at any time a utilization review agent's use of AI for utilization review
- The bill does not define the term 'artificial intelligence-based algorithm' and states no penalty
- Text takes effect September 1, 2025; no enrolled version exists, so the bill died at sine die adjournment
Latest legislative action
Mar 19, 2025. Referred to Insurance
Sponsors (showing 5 of 8)
| Name | Role |
|---|---|
| Buckley | Primary |
| Dutton | Primary |
| Garcia Hernandez, Cassandra | Primary |
| Guillen | Primary |
| Lalani | 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