Becker's Healthcare March 26, 2025
Several states are considering regulating how insurers can use AI in prior authorization.
In January, a California law took effect that prohibits payers from making coverage decisions based solely on artificial intelligence algorithms. The law requires any denial, delay or modification of care to be reviewed by a physician or other qualified healthcare provider.
Other states are considering similar actions. In 2025, lawmakers in Illinois, Georgia, Texas, Rhode Island, Minnesota and Florida have introduced laws that would restrict the use of AI in prior authorization decisions. None of the bills have passed their state legislatures as of March 26.
Insurers’ use of AI in prior authorization has come under scrutiny in recent years. UnitedHealth Group is facing...
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