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Delegate proposes ban on provider prior‑auth fees and on AI‑only denials; insurers urge overlap with other bills
Summary
House Bill 13-14 would ban health care providers from charging patients fees for prior authorization requests and would bar insurers from using AI to automatically deny prior authorizations; insurers told the committee the AI issue overlaps with other bills but supported prohibiting provider fees.
House Bill 13-14 would (1) prohibit health care providers from charging patients fees to complete prior authorization paperwork and (2) bar payers from using artificial intelligence systems to issue automatic prior‑authorization denials without human review.
Sponsor Delegate April Miller told the committee she encountered instances where physician offices were charging patients a fee — she reported hearing $35, later $15 — to process prior authorizations and said charging patients for a process imposed by insurers raises equity concerns. She also cited American Medical Association research and recent AMA policy urging oversight of payers’ AI use in medical necessity determinations.
Representatives of insurers and the League of Life and Health Insurers opposed parts of the bill as duplicative of House Bill 8-20, which the speaker noted had passed third reader on the floor earlier the same day and contains AI guardrails and related insurer obligations. Matt Celentano, representing the League (and insurers), said insurers operate under an April 2025 Maryland Insurance Administration/National Association of Insurance Commissioners bulletin and that human reviewers make adverse decisions; he expressed support for prohibiting provider fees for prior‑auth forms and asked the committee to consider an amendment to add that prohibition to other health bills if the committee prefers not to advance the broader AI language.
Committee members asked for technical coordination. The vice chair said the committee has addressed AI in prior bills and asked the sponsor and relevant delegates to coordinate on amendments. Legislators also asked whether a statutory prohibition on provider fees would be the appropriate vehicle; insurer representatives indicated they would support prohibiting the fee and that it should be “nipped in the bud.”
Ending: The committee closed the hearing and the sponsor and stakeholders agreed to coordinate on technical amendments and statutory placement of the fee prohibition if the committee chooses to act.
