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Bill

HB 2922

Relating to use of artificial intelligence in utilization review conducted for health benefit plans.

89th Legislature (2025) Introduced by Cas Garcia Hernandez and 3 co-sponsors

Texas bill requiring health insurers to establish safeguards and transparency standards for AI systems used in medical coverage decisions.

Referred to Insurance
#artificialintelligence(iq7c5) #electronicinformationsystems(i0311) #healthcareproviders(i0387) #insurance #commissionerof(v0396) #insurance--health&accident(i0422) #insurance--insurers&agents(i0425) #physicians(s1282)
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Bill Summary · HB 2922

Legislative bill overview

HB 2922 establishes regulatory requirements for the use of artificial intelligence in utilization review processes conducted by health insurance plans in Texas. The bill would impose standards on how insurers deploy AI systems when making decisions about whether to approve, deny, or modify coverage determinations for medical services and treatments.

Why is this important

Utilization review decisions directly affect patients' access to healthcare—delays or denials can postpone necessary treatments. As insurers increasingly automate these decisions using AI, there are concerns about algorithmic bias, lack of transparency, and insufficient human oversight. This bill addresses whether and how AI can be used in these consequential decisions that impact both patients and healthcare providers.

Potential points of contention

  • AI transparency and explainability: Determining what level of disclosure insurers must provide about how AI systems reach coverage decisions, and whether proprietary algorithms must be revealed to patients or regulators
  • Human review requirements: Whether decisions made or influenced by AI require mandatory human review before denial or modification, potentially increasing operational costs for insurers
  • Liability and accountability: Clarifying whether insurers, AI vendors, or both bear responsibility for harmful or discriminatory AI decisions, and what recourse patients have for algorithmic errors

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

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