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Lawmakers debate bill to curb insurer use of AI that overrides clinicians
Summary
Sponsor Rep. Grama proposed HB 14-06 to prohibit insurers' deployment of AI systems that change or override clinicians' coding and clinical determinations, require documentation of AI use for audits, and treat violations as unfair insurance practices; technical witnesses warned of opaque 'black-box' models while insurers and the Insurance Department pointed to existing human-review safeguards and ongoing rulemaking.
Representative Grama told the committee HB 14-06 would protect clinicians' professional judgment by preventing insurers from using AI systems to change provider codes or otherwise override clinical coding decisions without a qualified human review.
"Clinical coding decisions should remain with the clinicians who actually examine and treat patients," the sponsor said, describing instances elsewhere where automated processes were used to deny claims and citing fast automated processing times and high overturn rates in outside…
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