New York Senate Bill S07896

New York 2025-2026 Regular Session

• Introduced: 5/13/25
• Refer: 5/13/25

Caption

Prescribes requirements and safeguards for the use of an artificial intelligence, algorithm, or other software tool for the purpose of utilization review for health and accident insurance.

Impact

By establishing clear guidelines for the use of AI, this legislation could lead to significant changes in how health insurers evaluate claims and determine coverage for their policyholders. Insurers using these technologies must comply with comprehensive criteria that include safeguarding against discrimination and ensuring fairness in the application of AI tools. This would likely enhance the credibility of AI in the healthcare sector and align its use with existing regulations to prevent potential biases and preserve patient rights.

Summary

Bill S07896 introduced in New York aims to amend the public health law and insurance law to outline requirements and safeguards for the utilization of artificial intelligence (AI), algorithms, or other software tools in the context of health and accident insurance. The bill emphasizes incorporating specific medical criteria when AI is employed for utilization reviews, which assess the necessity of healthcare services. This initiative seeks to ensure that AI tools do not entirely replace provider decision-making nor base their determinations solely on group datasets, thereby maintaining a degree of human oversight in critical health decisions.

Contention

However, there may be contention regarding the balance between technological efficiency and the preservation of personalized healthcare. As AI becomes more ingrained in medical decision-making, concerns could arise about over-reliance on technology versus the nuanced understanding of medical professionals. Some stakeholders might argue that these regulations are either too restrictive or not sufficient enough to genuinely protect patient interests, depending on their perspectives on technology in healthcare.