Texas 2025 - 89th Regular

Texas Senate Bill SB1822 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Johnson S.B. No. 1822
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	2	+	(In the Senate - Filed March 3, 2025; March 13, 2025, read
	3	+	first time and referred to Committee on Health & Human Services;
	4	+	March 31, 2025, reported adversely, with favorable Committee
	5	+	Substitute by the following vote: Yeas 8, Nays 1; March 31, 2025,
	6	+	sent to printer.)
	7	+	Click here to see the committee vote
	8	+	COMMITTEE SUBSTITUTE FOR S.B. No. 1822 By: Blanco
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6	11		A BILL TO BE ENTITLED
7	12		AN ACT
8	13		relating to the use of artificial intelligence-based algorithms in
9	14		utilization review conducted for certain health benefit plans.
10	15		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	16		SECTION 1. Subchapter D, Chapter 4201, Insurance Code, is
12	17		amended by adding Section 4201.156 to read as follows:
13	18		Sec. 4201.156. ARTIFICIAL INTELLIGENCE-BASED ALGORITHMS.
14	19		(a) An issuer of a health insurance policy or a health maintenance
15	20		organization that is the issuer of a health benefit plan shall
16	21		publish on a publicly accessible part of the issuer's Internet
17	22		website and provide in writing to each insured or enrollee, and to
18	23		any physician or health care provider contracting with the issuer
19	24		or providing services to an insured or enrollee, a written
20	25		disclosure regarding whether the issuer or the issuer's utilization
21	26		review agent uses artificial intelligence-based algorithms in
22	27		conducting utilization review.
23	28		(b) An issuer described by Subsection (a) or a utilization
24	29		review agent for an issuer described by Subsection (a) shall ensure
25	30		that any artificial intelligence-based algorithm used by the issuer
26	31		or agent in conducting utilization review and the training data
27	32		sets the algorithm uses:
28	33		(1) have minimized the risk of bias based on an
29	34		individual's race, color, religion, ancestry, age, sex, gender,
30	35		national origin, or disability; and
31	36		(2) comply with evidence-based clinical guidelines.
32	37		(c) Not later than December 31 of each year, an issuer
33	38		described by Subsection (a) or a utilization review agent for an
34	39		issuer described by Subsection (a) shall submit to the department
35	40		for review, in the form and manner prescribed by the commissioner,
36	41		an artificial intelligence compliance statement. The statement
37	42		must:
38	43		(1) summarize the function and scope of an artificial
39	44		intelligence-based algorithm used for utilization review;
40	45		(2) provide a logic or decision tree of an artificial
41	46		intelligence-based algorithm used for utilization review;
42	47		(3) provide a description of each training data set
43	48		used by an artificial intelligence-based algorithm for utilization
44	49		review, including the source of the data;
45	50		(4) attest that the artificial intelligence-based
46	51		algorithm and the algorithm's training data sets comply with
47	52		Subsection (b); and
48	53		(5) describe the issuer's or agent's process for
49	54		overseeing and validating the artificial intelligence-based
50	55		algorithm's performance and compliance with Subsection (b).
51	56		(d) If the commissioner has reason to believe that an issuer
52	57		described by Subsection (a) or utilization review agent for an
53	58		issuer described by Subsection (a) is not in compliance with this
54	59		section, the commissioner may require additional documentation or
55	60		conduct an inspection of:
56	61		(1) any artificial intelligence-based algorithm used
57	62		by the issuer or agent in conducting utilization review; and
58	63		(2) each training data set the artificial
59	64		intelligence-based algorithm uses.
60	65		(e) Information submitted to the department under this
61	66		section is confidential and not subject to disclosure under Chapter
62	67		552, Government Code.
63	68		SECTION 2. This Act takes effect September 1, 2025.
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