Relating to use of artificial intelligence in utilization review conducted for health benefit plans.
The enactment of HB2922 would likely impact state laws by establishing stringent guidelines for how artificial intelligence can be integrated into healthcare decision-making processes. Specifically, it reinforces the authority of qualified healthcare professionals in determining the appropriateness of healthcare services and ensures that their judgment cannot be overridden by algorithmic outputs. This change is intended to enhance patient safety and maintain the integrity of medical decisions. The bill also mandates that the commissioner has the authority to audit the use of AI by review agents, thereby increasing regulatory oversight in the industry.
House Bill 2922 introduces significant regulations regarding the use of artificial intelligence in the utilization review process for health benefit plans. The bill specifically prohibits utilization review agents from solely relying on AI-based algorithms to deny, delay, or modify healthcare services based on medical necessity. Instead, only licensed healthcare providers, such as physicians, are permitted to make such determinations, emphasizing the need for human oversight in critical healthcare decisions. This legislative move aims to safeguard patients from potential biases or inaccuracies that could arise from automated systems making healthcare decisions without professional input.
While the bill aims to address the ethical concerns surrounding the use of AI in healthcare, it may prompt discussions about the future of technological integration in the field. Supporters of the bill argue that it is crucial to protect patient welfare and uphold the standards of care that only qualified providers can offer. However, opponents may raise concerns about the implications for efficiency and cost-effectiveness in the healthcare system, arguing that AI has the potential to streamline processes and reduce administrative burdens. The key point of contention lies in finding a balance between leveraging technology and ensuring that healthcare remains a human-centered service.