Bill > HB2922

This bill adds a new section to the Texas Insurance Code that restricts how artificial intelligence (AI) can be used in utilization review, which is the process of evaluating the medical necessity and appropriateness of healthcare services. Specifically, the bill prohibits utilization review agents from using AI-based algorithms as the sole basis for denying, delaying, or modifying healthcare services for an enrollee. The legislation emphasizes that only a licensed physician or healthcare provider can make final determinations about the medical necessity or appropriateness of healthcare items and services. Additionally, the bill grants the insurance commissioner the authority to audit and inspect how utilization review agents are using artificial intelligence in their review processes. The new regulations will take effect on September 1, 2025, giving healthcare organizations and insurers time to adjust their practices to comply with the new requirements. The aim of the bill appears to be ensuring that AI is not used as a replacement for professional medical judgment in healthcare decision-making.

Business and Industry

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB2922