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Senate panel debates bill to limit use of AI in insurer coverage denials; sponsors, providers and plans disagree on scope
Summary
A Senate committee debated a substitute to Senate Bill 815 that would bar insurers from using AI as the sole basis to deny, delay or modify covered health-care services and would require disclosure when AI is used.
A heated debate unfolded in the Senate Business & Commerce Committee over Senate Bill 815, a substitute that would prohibit insurers from using artificial intelligence algorithms as the sole basis to deny, delay or modify health-care services and would require disclosure when an insurer uses AI in claims decisions.
Senator Charles Schwartner, the bill's sponsor, opened the discussion by saying: "Insurers are deploying artificial intelligence that's focused on their bottom line, in my opinion, over patients' well-being." The substitute expands the statutory definition of "adverse determination" to include downcoding and requires a human reviewer for medical necessity decisions.
Why it matters: The substitute targets the role of…
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