House Bill No. [insert bill number] aims to revise laws concerning the use of artificial intelligence (AI) in health insurance, specifically focusing on utilization review and management functions. The bill mandates that health insurance issuers using AI must ensure that their systems consider individual medical histories and clinical circumstances, rather than relying solely on group datasets. Additionally, the AI tools must not replace healthcare provider decision-making, must comply with state and federal laws, and must not discriminate against enrollees. The bill also stipulates that determinations of medical necessity can only be made by licensed healthcare professionals, and it requires regular reviews of the AI's performance to ensure accuracy and reliability.

Furthermore, the bill amends Section 33-18-201 of the Montana Code Annotated to prohibit the use of AI in ways that do not align with the new regulations established in Section 1. It introduces a new provision that explicitly states that health insurance issuers cannot use AI in a manner that contravenes the guidelines set forth in the bill. This legislation aims to enhance the oversight and accountability of AI applications in health insurance, ensuring that they are used ethically and effectively while protecting the rights of enrollees.

Statutes affected:
LC Text: 33-18-201
HB0556_1(1): 33-18-201
HB0556_1(2): 33-18-201
HB0556_1(3): 33-18-201
HB0556_1: 33-18-201