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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.
This bill relates to the use of AI by insurers in utilization reviews and establishes notice requirements for adverse determinations.
If you are an insurer using AI for utilization reviews, you must notify insureds and health care providers about AI usage by policy renewal or face penalties.
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Affected Industries
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What This Means
The bill introduces regulations on the use of artificial intelligence in the insurance sector, particularly for utilization reviews. It aims to enhance transparency and accountability in automated decision-making processes affecting health care services.
Key Provisions
- The bill addresses the use of AI in utilization reviews.
- The specific penalties for non-compliance cannot be confirmed without the full bill text.
- The bill text does not confirm exemptions for AI usage without notice.
Latest Legislative Action
REFERRED TO INSURANCE
Bill Sponsors
| Name | Role | District |
|---|---|---|
| Michelle Hinchey D | Sponsor | SD-041 |
Compliance Checklist
Who: Insurers
Deadline: At policy renewal and annually
Penalty: Fines up to $10,000 for willful violations
Who: Insurers
Deadline: As specified by the superintendent
Penalty: License suspension or revocation
Related & Companion Bills
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