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SB 13

AN ACT RELATING TO INSURANCE -- THE TRANSPARENCY AND ACCOUNTABILITY IN ARTIFICIAL INTELLIGENCE USE BY HEALTH INSURERS TO MANAGE COVERAGE AND CLAIMS ACT

2025 Regular Session Introduced by Jonathon Acosta and 9 co-sponsors

Rhode Island requires health insurers to disclose AI use in coverage and claims decisions, establishing transparency and accountability for automated denials affecting patient care.

06/10/2025 Senate passed Sub A
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WeVote Research Nonpartisan
Bill Summary · SB 13

Legislative bill overview

SB 13 requires health insurers in Rhode Island to disclose when they use artificial intelligence in coverage decisions and claims management, and mandates transparency about how these AI systems operate. The bill establishes accountability mechanisms for insurers deploying automated decision-making that affects patient care and reimbursement.

Why is this important

Health insurers increasingly use AI algorithms to deny claims, determine coverage eligibility, and manage utilization—decisions that directly impact patient access to medical care. Without transparency requirements, patients and providers cannot understand or challenge these automated denials, potentially trapping them in disputes with algorithmic systems they cannot see. This bill attempts to create visibility into a largely opaque process that affects millions of healthcare decisions annually.

Potential points of contention

  • Implementation burden: Insurers may argue that detailed AI disclosure requirements are operationally complex and costly, potentially raising premiums for consumers
  • Proprietary concerns: Insurance companies often treat their algorithmic models as trade secrets; mandatory transparency could face legal challenges over intellectual property protection
  • Enforcement clarity: The bill's recent amendments (Substitute A) may lack clear enforcement mechanisms, penalties, or definition of what "transparency" concretely requires, making compliance ambiguous
  • AI system complexity: Modern machine learning models operate in ways even their creators struggle to explain ("black box" problem), raising questions about whether meaningful transparency is technically feasible

Compiled from official sources — confirm details with the bill’s official record.

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