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Panel backs 'Patients First' bill limiting AI-only claim denials and creating review commission
Summary
HB2619 would require human review of insurance claim denials flagged by algorithms and create a Tennessee Commission of Insurance Review; sponsor argued the bill will increase fairness and oversight after citing examples of alleged downcoding and payment disparities.
Chairman Howe (speaker 18) described HB2619 as protecting patients and ensuring that medical decisions are made by qualified health-care providers rather than solely by algorithmic systems. The sponsor said algorithms can flag claims but cannot make final determinations; a human provider must make the final decision.
Members asked about fiscal impacts and whether algorithm adoption saved insurers money. Representative McKenzie noted the fiscal note and asked whether AI efficiencies were considered; the sponsor said the fiscal note reflected costs of creating a new commission (including staffing a full-time director) and that the reimbursement-equity portion that previously drew a larger fiscal estimate had been removed from the current draft. The sponsor cited an example of a rural 250-bed hospital whose claimed payment dispute was settled and framed the bill as an accountability measure to address downcoding and underpayment. The committee voted 13–0 to send HB2619 to Finance, Ways and Means.
