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Bill

SB 1967

Hospital and Medical Services Utilization Review Act; requiring utilization review organization that uses AI to adhere to requirements; prohibiting AI from making certain determinations. Effective date.

2026 Regular Session Introduced by Mark Mann

Oklahoma bill restricts AI-only determinations in insurance utilization reviews, requiring human oversight for medical coverage decisions affecting patient care access.

Second Reading referred to Technology and Telecommunications
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Bill Summary · SB 1967

Legislative bill overview

SB 1967 establishes regulatory requirements for utilization review organizations (UROs) in Oklahoma that employ artificial intelligence systems. The bill prohibits AI from making autonomous determinations in medical utilization reviews and mandates adherence to specific standards for AI-assisted decision-making in healthcare coverage determinations.

Why is this important

Utilization review organizations currently determine whether insurance will cover medical procedures and treatments. As AI becomes more prevalent in healthcare decisions, this bill addresses concerns that algorithms could deny necessary care without human oversight or accountability, potentially affecting patient access to medical services and provider reimbursement.

Potential points of contention

  • AI decision-making limits: The bill's specific prohibition on what AI "cannot determine" may be too narrow or too broad depending on the final language—either failing to protect patients or imposing compliance burdens on insurers and UROs
  • Implementation costs: Healthcare organizations may argue that AI restrictions increase operational costs, potentially leading to higher insurance premiums or reduced use of efficiency-enhancing technology
  • Definition clarity: Terms like "determinations" versus "recommendations" need precise definition to avoid loopholes where AI effectively makes decisions while technically only assisting humans
  • Competitive impact: Restrictions could disadvantage Oklahoma-based healthcare companies versus out-of-state competitors with different regulatory environments

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

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