The bill, H.B. No. 2922, introduces new regulations regarding the use of artificial intelligence in utilization reviews for health benefit plans in Texas. It amends the Insurance Code by adding Section 4201.156, which stipulates that utilization review agents are prohibited from using artificial intelligence-based algorithms as the sole basis for decisions that deny, delay, or modify health care services based on medical necessity. Instead, such determinations must be made by a physician or licensed health care provider in accordance with existing regulations.

Additionally, the bill grants the commissioner the authority to audit and inspect the utilization review agents' use of artificial intelligence at any time. This legislation aims to ensure that decisions affecting patient care are made by qualified professionals rather than relying solely on automated systems. The provisions of this act are set to take effect on September 1, 2025.

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