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LD 1301

An Act To Prohibit The Use Of Artificial Intelligence In The Denial Of Health Insurance Claims

132nd Legislature (2025-2026) Introduced by Poppy Arford and 9 co-sponsors

Prohibits AI as the sole or primary basis for denying health insurance claims, protecting claimants and ensuring human review.

Pursuant to Joint Rule 310.3 Placed in Legislative Files (DEAD)
#claims #healthinsurance #insurance
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Bill Summary · LD 1301

LD 1301: An Act To Prohibit The Use Of Artificial Intelligence In The Denial Of Health Insurance Claims

Overview

LD 1301 seeks to prohibit the use of artificial intelligence in denying health insurance claims. The bill’s title indicates a restriction on AI-based decision-making in the claim denial process, with the aim of ensuring that denials are not determined solely by AI systems.

Purpose and intent

  • To prevent health insurers from using artificial intelligence as the sole or primary basis for denying health insurance claims.
  • To strengthen safeguards around claim denial decisions and potentially ensure human oversight or review in the decision-making process (exact mechanisms would be specified in the bill’s text).
  • To protect claimants from AI-driven denials and promote transparency and accountability in claims handling.

Note: The provided information does not include the bill’s full text, definitions, or specific procedural requirements. The summary focuses on the stated objective conveyed by the title and available legislative actions.

Key provisions (as introduced)

  • The primary provision reflected by the title prohibits the use of artificial intelligence in denying health insurance claims.
  • Details such as definitions (what constitutes “artificial intelligence”), scope (types of health insurance plans affected), exceptions, enforcement, penalties, and implementation timelines are not provided in the available materials. The enacted text would specify these elements.

Who/what would be affected

  • Health insurance issuers and third-party claims processors that adjudicate claim denials.
  • Policyholders, insured individuals, and claimants challenging coverage or payment decisions.
  • Health care providers involved in the claims process (indirectly, as they may reference claim outcomes).

Procedural and timeline aspects

  • Introduced: March 25, 2025.
  • Committee referral: Referred to the Committee on Health Coverage, Insurance and Financial Services on March 25, 2025.
  • Legislative actions:
    • 2025-03-25: In concurrence; referred to the committee for concurrence.
    • 2025-03-25: Suggested and ordered printed; reference to the committee.
    • 2025-04-16, 2025-05-08, 2025-05-15: Work sessions Held – TABLED.
    • 2025-05-16: Carry Over Requested.
    • 2025-05-19: Carry Over Approved.
    • 2025-06-25: CARRIED OVER, in the same posture, to any special or regular session of the 132nd Legislature, pursuant to Joint Order SP 800.
  • Status: CARRIED OVER to future sessions of the 132nd Legislature (special or regular), keeping the bill in consideration.

Next steps for readers

  • The exact text, definitions, and any amendments will be critical to understanding how the prohibition would operate in practice. Interested readers should review the bill’s full language when available, particularly any definitions of “artificial intelligence,” scope of applicability (individual vs. group plans), enforcement provisions, and any transitional provisions.

If you’d like, I can tailor a comparison with existing Maine protections or similar bills from other states once the full text is available.

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

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