Senate Bill No. SLS 26RS-545 establishes new requirements for health insurance issuers that utilize artificial intelligence (AI) or automated decision systems in their processes. The bill amends existing law to mandate that insurers inform policyholders if AI or automated systems were used in making adverse determinations regarding claims. It also defines "artificial intelligence" and "automated decision systems," and outlines specific conditions under which these technologies can be employed, ensuring that they do not replace the role of healthcare providers in decision-making. Additionally, the bill requires that any adverse determination must be signed by a licensed physician who has reviewed the relevant medical records.

The legislation further stipulates that any adverse determination influenced by AI or automated systems is presumed invalid unless the insurer can demonstrate that the decision was independently reached without reliance on algorithmic output. Insured individuals are granted the right to appeal such determinations and to access all documents related to the use of AI in the review process. The bill also allows the commissioner to audit the use of these technologies for compliance and mandates that insurers disclose specific information about their AI systems. The provisions of this act will apply to new policies issued on or after January 1, 2027, with existing policies required to conform by their renewal date, but no later than January 1, 2028.

Statutes affected:
SB246 Original: 22:44(E)(2)
SB246 Engrossed: 22:44(E)(2)