Algorithm and AI use prohibited during health insurance prior authorization request review.
Impact
If enacted, HF2500 would have significant implications for how health insurance plans operate within Minnesota. The prohibition of AI and algorithms in prior authorization decisions may enhance patient advocacy by increasing the likelihood that cases are reviewed on a more qualitative basis. Advocates of the bill argue that relying on human judgement will mitigate potential biases embedded in algorithms and safeguard patient rights. The law is set to go into effect on January 1, 2026, applying to all health plans offered, sold, issued, or renewed thereafter, indicating a substantial shift in health policy that will necessitate changes in the practices of health insurers going forward.
Summary
House File 2500 (HF2500) addresses the use of algorithms and artificial intelligence in the health insurance industry, specifically prohibiting their application in the review of prior authorization requests. This legislative measure aims to amend Minnesota Statutes 2024, section 62A.59, by adding a new subdivision that explicitly forbids health carriers from leveraging AI technology or algorithms when making decisions regarding the approval or denial of prior authorization requests. The goal of this bill is to safeguard the integrity of insurance review processes and ensure that these decisions are made based on human judgement rather than automated systems.
Contention
However, the bill has not been without contention. Critics argue that the use of algorithms has the potential to effectively streamline operations and ensure a more consistent application of prior authorization criteria across different cases. They may raise concerns about the potential for increased workloads for human reviewers and question the efficacy of the bill in improving patient access to necessary medical care. Additionally, the debate intersects with broader discussions on technology's role in healthcare and regulation, making HF2500 a focal point in ongoing conversations about health policy and innovation.
Prior authorization and coverage of health services requirements modification; ground for disciplinary action against physicians modification; commissioner of commerce and legislature report requirements; classifying data
Health care service prior authorization and coverage requirements modified, ground for disciplinary action against physicians modified, reports to the commissioner of commerce and the legislature required, data classified, and rulemaking authorized.
Health insurance; preexisting condition limitations prohibited in Medicare supplement insurance policies, and Medicare supplement benefits governing provisions modified and added.