This bill prohibits, beginning January 1, 2026, health insurance carriers from denying coverage or claims for services under a health plan solely based on the use of artificial
43 intelligence. The bill requires that, before a carrier denies benefits or reduces payment for
44 services using artificial intelligence, a carrier must conduct a utilization review done by a
45 physician who is licensed in this State that includes a review of the medical necessity of
46 the services, the professional judgment of the enrollee's provider and the impact of any
47 denial of benefits or reduction in payment on the enrollee's health outcomes. The bill
48 requires carriers and the Department of Professional and Financial Regulation, Bureau of
49 Insurance to report on a quarterly and annual basis, respectively, on the use of artificial
50 intelligence. The bill also requires the bureau to adopt rules related to the use of artificial
51 intelligence by carriers no later than November 1, 2025.