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Bill

A 1456

Relates to the use of artificial intelligence for utilization review

2025 Regular Session Introduced by Pamela Hunter

Regulates AI use in health insurance utilization review, requiring transparency, human oversight, and protections for patients and providers in AI-driven decisions.

REFERRED TO INSURANCE
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Bill Summary · A 1456

Summary: Assembly Bill A 1456 – Relates to the use of artificial intelligence for utilization review

Basic bill information

  • Bill Number: A 1456
  • Title: Relates to the use of artificial intelligence for utilization review
  • Status: Referred to Insurance
  • Introduced: January 9, 2025
  • Classification: Bill
  • Sponsor: Pamela J. Hunter (primary)
  • Related bills: A 9149 (prior-session)

Purpose and intent

  • The bill, by its title, aims to address how artificial intelligence (AI) is used in utilization review within the health insurance context. Utilization review generally involves evaluating the appropriateness, medical necessity, and efficiency of proposed or completed medical services for insured individuals.
  • Specific objectives, definitions, standards, and requirements are not provided in the information available here. The bill’s exact scope—what forms of AI are covered, in what stages of utilization review AI would be used, and under what oversight—would be detailed in the bill text.

Known provisions (from available information)

  • The text of the bill is not included in the provided material, so concrete provisions, requirements, or prohibitions cannot be enumerated here.
  • What can be stated with certainty based on the title and status:
    • The bill would regulate the use of AI in utilization review processes undertaken by insurers or related entities.
    • It has advanced to the committee stage in the Legislature, specifically the Insurance committee.

Potential topics likely addressed (not confirmed in provided text)

While the exact provisions are not available, bills of this type commonly address:
- Definitions of AI, machine learning, and decision-support tools used in utilization review.
- Requirements for transparency and disclosure to patients and providers about AI involvement.
- Standards for accuracy, validation, and ongoing monitoring of AI systems.
- Human oversight obligations, including mandatory clinician review for AI-driven determinations.
- Data privacy, security, and handling of patient information in AI systems.
- Accountability and method for contesting AI-based decisions.
- Timelines for compliance, enforcement mechanisms, and penalties for noncompliance.
- Procurement, procurement transparency, and vendor accountability for AI tools.

Who would be affected

  • Insurers and insurance-related entities employing AI in utilization review.
  • Healthcare providers who submit requests or appeals for covered services subject to utilization review.
  • Patients/insured individuals receiving care subject to AI-assisted determinations.
  • AI vendors and developers supplying utilization review tools and algorithms.

Procedural history and timeline

  • January 9, 2025: Introduced and referred to the Insurance committee (first noted action).
  • The material shows the same action listed twice, indicating the referral was recorded in the legislative actions on that date.
  • No further actions, dates, or committee votes are provided here.

Related legislation

  • A 9149 (prior-session) is listed as related, suggesting there may be ongoing or historical consideration of AI in utilization review within this legislative context.

Next steps for readers

  • Obtain the full bill text to review:
    • Definitions, specific prohibitions or allowances for AI in utilization review.
    • Any required human oversight, transparency provisions, data protections, and enforcement mechanisms.
    • Effective dates, compliance timelines, and oversight processes.
  • Monitor updates from the Insurance committee for hearings, amendments, and votes.
  • Review related bill A 9149 for context on prior-session considerations.

If you’d like, I can summarize the bill in more depth once the official text is available or if you provide the bill’s language.

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

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