Insurance: health insurers; use of artificial intelligence tools to make decisions regarding claims; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ss.
Impact
The bill's passage would require insurers operating in Michigan to re-evaluate their claims processing protocols, ensuring that human oversight remains a critical component in claims review. This could lead to a significant shift in how insurance companies approach decision-making for claims, possibly increasing operational costs as additional human resources may be needed. On a broader scale, it may also influence how AI technology is integrated into various industry practices in Michigan, potentially setting a precedent for other states to follow.
Summary
House Bill 4536 seeks to amend the Insurance Code of 1956 by introducing a new section that specifically addresses the use of artificial intelligence (AI) in health insurance claims processing. The bill stipulates that health insurers cannot deny, modify, or delay a claim based on a review conducted by AI tools. This legislation aims to ensure that consumers are protected from potential biases or errors introduced by automated decision-making systems, thereby promoting fairness in the insurance claims process.
Contention
While supporters of HB4536 argue that it is essential for consumer protection and to avoid the pitfalls of AI-driven decisions, critics may raise questions about the implications this could have on the efficiency and speed of claims processing. Opponents might argue that this regulation could slow down responses to claims and disrupt the potential advantages AI can offer in terms of speed and accuracy. Balancing the use of technology with consumer rights will likely be a central theme in discussions surrounding the bill.
Insurance: health insurers; denying coverage for preexisting conditions; prohibit, and prohibit canceling coverage based on health of insured. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ii.
Insurance: health insurers; limitations on duration of inpatient psychiatric admissions; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406mm.
Insurance: health insurers; certain annual reports of health insurers relating to mental health parity; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406cc.
Insurance: health insurers; annual and lifetime dollar limits; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406z. TIE BAR WITH: HB 4623'23
Insurance: health insurers; coverage for mental health screenings for new mothers; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406oo.
Insurance: health insurers; issuing rebates to an insured if the insured does not meet medical loss ratio; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406jj.