The bill, known as the "Use of Artificial Intelligence in Medical Decisions Transparency Act," establishes regulations for health insurers and utilization review organizations that utilize artificial intelligence (AI) in their decision-making processes regarding medical necessity. It mandates that all determinations of medical necessity must be made by a competent licensed physician or healthcare professional, ensuring that AI does not solely dictate healthcare decisions. The bill outlines specific requirements for the use of AI, including that it must consider individual clinical circumstances, not rely solely on group datasets, and must not discriminate against enrollees. Additionally, it emphasizes the importance of periodic reviews of AI tools to maximize their accuracy and reliability.

Furthermore, the bill requires health insurers to create and file written policies and procedures with the Kansas Department of Insurance that detail how they review and make decisions regarding healthcare services based on medical necessity. These policies must align with clinical principles and be disclosed to insured individuals, healthcare providers, and the public upon request. The act aims to enhance transparency and accountability in the use of AI in healthcare decision-making while safeguarding the role of qualified healthcare professionals in determining medical necessity.