Bill > A01456

This bill introduces new regulations for insurers, health corporations, and health maintenance organizations regarding the use of artificial intelligence (AI) in utilization review, which is a process for evaluating the medical necessity and appropriateness of healthcare services. The bill requires these entities to notify insureds and enrollees about their use of AI-based algorithms on their websites and to submit these algorithms and training data sets to the state department for review. The department must assess these AI systems to ensure they minimize bias based on protected characteristics like race, age, and gender, and adhere to evidence-based clinical guidelines. Clinical peer reviewers must now manually review individual clinical records before issuing an adverse determination when AI is initially used. The bill establishes penalties for non-compliance, including potential license suspension or revocation, fines up to $5,000 or $10,000 per violation (with aggregate annual limits), and requires the superintendent to create implementation rules. The legislation aims to increase transparency, reduce potential algorithmic bias, and maintain human oversight in healthcare decision-making processes. The law will take effect 60 days after becoming law.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/A1456