89R10420 SCL-D
By: Johnson S.B. No. 1822
A BILL TO BE ENTITLED
AN ACT
relating to the use of artificial intelligence-based algorithms in
utilization review conducted for certain health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter D, Chapter 4201, Insurance Code, is
amended by adding Section 4201.156 to read as follows:
Sec. 4201.156. ARTIFICIAL INTELLIGENCE-BASED ALGORITHMS.
(a) An issuer of a health insurance policy or a health maintenance
organization that is the issuer of a health benefit plan shall
publish on a publicly accessible part of the issuer's Internet
website and provide in writing to each insured or enrollee, and any
physician or health care provider contracting with the issuer or
providing services to an insured or enrollee, a disclosure
regarding whether the issuer or the issuer's utilization review
agent uses artificial intelligence-based algorithms in conducting
utilization review.
(b) An issuer described by Subsection (a) or a utilization
review agent for an issuer described by Subsection (a) shall ensure
that any artificial intelligence-based algorithm used by the issuer
or agent in conducting utilization review and the training data
sets the algorithm uses:
(1) have minimized the risk of bias based on an
individual's race, color, religion, ancestry, age, sex, gender,
national origin, or disability; and
(2) comply with evidence-based clinical guidelines.
(c) Not later than December 31 of each year, an issuer
described by Subsection (a) or a utilization review agent for an
issuer described by Subsection (a) shall submit to the department
for review, in the form and manner prescribed by the commissioner,
any artificial intelligence-based algorithm used by the issuer or
agent in conducting utilization review and each training data set
the algorithm uses. The issuer or agent must include with the
submission an attestation to the department that the algorithm and
training data sets comply with Subsection (b).
SECTION 2. This Act takes effect September 1, 2025.