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Bill

H 776

An act relating to the use of artificial intelligence in health care coverage decisions

2025-2026 Regular Session Introduced by Elizabeth Burrows and 19 co-sponsors

Vermont H 776 aims to require transparency, accountability, and safeguards when using AI to make health coverage decisions, including explainability, oversight, and non-discriminat

Read first time and referred to the Committee on Health Care
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WeVote Research Nonpartisan
Bill Summary · H 776

Summary of Bill H 776 (2025-2026) – Vermont

Purpose and overall aim

  • H 776 is an act relating to the use of artificial intelligence (AI) in health care coverage decisions.
  • The bill appears to address how AI tools and algorithms are used when determining whether a health care service, procedure, or diagnosis is covered by health insurance or public health programs in Vermont.
  • The central goal is to ensure that AI-driven coverage decisions are transparent, accountable, and protective of enrollees, with standards to safeguard patient rights and clinical appropriateness.

Key provisions and changes (as introduced)

  • Transparency and disclosure:
    • Requires disclosure when AI algorithms are used to inform coverage determinations.
    • Potentially mandates explanations of AI-based decisions to patients and providers, including the factors and inputs used by the AI system.
  • Accountability and oversight:
    • Establishes standards for the validation, performance, and ongoing monitoring of AI tools used in coverage decisions.
    • May require audits or reporting to a health care regulator (e.g., Department of Health or another appropriate Vermont entity) regarding AI usage in coverage determinations.
  • Clinical appropriateness and non-discrimination:
    • Ensures AI-assisted decisions do not override clinical judgment or established evidence-based guidelines when it would harm patient care.
    • Prohibits the use of biased or discriminatory algorithms that would privilege or deny coverage based on non-medical characteristics (e.g., race, gender, age, disability).
  • Consumer protections:
    • Provides enrollees and providers with a process to challenge AI-driven coverage decisions.
    • May outline timelines for appeals and required reconsideration by human reviewers.
  • Data and privacy:
    • Addresses data governance, including the handling, storage, and privacy of health information used by AI systems in coverage determinations.
    • Likely references compliance with applicable state and federal privacy laws.
  • Scope and applicability:
    • Applies to public programs (e.g., Vermont Medicaid) and private health plans operating in Vermont, where AI is used to decide coverage.
    • Clarifies exceptions or limits for certain types of decisions or for emergency situations.

Who would be affected

  • Enrollees and patients whose health care coverage decisions are guided or informed by AI tools.
  • Health care providers making or appealing coverage determinations on behalf of patients.
  • Health insurers, including private plans and state programs, that deploy AI to aid in coverage decisions.
  • State regulators and health agencies responsible for oversight, compliance, and enforcement.
  • Vendors and developers of AI systems used in coverage determinations, who may be subject to validation, disclosure, and audit requirements.

Procedural and timeline aspects

  • Status: Read first time and referred to the Committee on Health Care as of 2026-01-27.
  • Next steps (typical for such a bill): Committee consideration, potential amendments, and eventual floor action by the Vermont General Assembly. If advanced, the bill would proceed through readings, hearings, and votes, with opportunities for stakeholder input and public testimony.
  • Enactment timeline would depend on committee recommendations and legislative scheduling, including any effective dates for the new requirements (e.g., phased deadlines for compliance, if specified in later amendments).

Notable considerations for readers

  • This bill signals Vermont’s interest in governing the use of AI in health care coverage decisions, balancing innovation with patient rights and clinical integrity.
  • The emphasis is likely on transparency (explainability of AI decisions), accountability (human oversight and redress mechanisms), and equity (preventing discriminatory practices).
  • If enacted, insurers and providers may need to update policies, training, and data governance practices to align with new requirements.

If you’d like, I can tailor the summary further to include potential fiscal implications, specific enforcement mechanisms, or provide a side-by-side comparison with existing Vermont consumer protection or health care transparency laws.

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

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