Bill > S0013

This bill establishes the Transparency and Accountability in Artificial Intelligence Use by Health Insurers to Manage Coverage and Claims Act, which requires health insurers in Rhode Island to provide detailed disclosure and oversight of their artificial intelligence (AI) systems used in healthcare claims and coverage decisions. The legislation mandates that insurers reveal the types of AI models they use, their decision-making processes, training datasets, performance metrics, and governance policies to the Office of Health Insurance Commissioner (OHIC) and Department of Business Regulation (DBR). Insurers must maintain documentation of AI-influenced decisions for five years and ensure that any adverse benefit determination made by an AI system is reviewed and approved by a qualified healthcare professional before finalization. The bill defines key terms like "artificial intelligence" as a machine-based system that can make predictions or decisions, and "medically necessary care" as services required for preventing, diagnosing, or treating health conditions. Annually, DBR/OHIC must submit a comprehensive report to state leadership detailing how health insurers are using AI, including specifics on model types, decision-making processes, data governance, and performance metrics. The legislation aims to increase transparency, prevent potential biases, and ensure that AI systems do not arbitrarily deny healthcare claims, with the provisions set to take effect on June 30, 2026.

Business and Industry

https://status.rilegislature.gov/