The bill aims to regulate the use of artificial intelligence (AI) by health benefit plan providers in making coverage determinations under health benefit plans in Alabama. It defines key terms related to health benefit plans and establishes that any AI used for determining medical necessity must consider the enrollee's medical history and unique clinical circumstances. Health benefit plan providers are required to certify annually that their AI systems comply with specific standards, including non-discrimination and fair application. Additionally, any denial or modification of prior authorization requests based on AI assessments must be made by a licensed physician or qualified health care professional.

The bill also empowers the Alabama Department of Insurance to investigate potential violations of these regulations and impose disciplinary actions, including administrative fines and the suspension or revocation of a provider's authority to operate. The department is tasked with ensuring compliance through periodic reviews and requires health benefit plan providers to disclose their use of AI in utilization reviews. The act is set to take effect on October 1, 2026.

Statutes affected:
Introduced: 27-1-2
Engrossed: 27-1-2
Enrolled: 27-1-2