An Act relating to health insurance; providing definitions; prohibiting utilization review agents from using an automated system to make adverse determinations; permitting Insurance Commissioner auditing authority; clarifying act does not prohibit use of automated decision systems for administrative support or fraud detection; directing notice of adverse determinations to include certain information; providing for codification; and providing an effective date.
One Reply to “HB 3675 (2026)”
HB 3675 prohibits health insurance utilization review agents from finalizing adverse determinations based on an algorithm or AI system unless a qualified human medical professional reviews it first.
It also gives the Insurance Commissioner authority to audit how insurers are using automated decision systems, while still allowing automation for admin support and fraud detection. The measure outlines further denial notice requirements.
Effective November 1, 2026.
Comments are closed.