Bill > HB4635

This bill introduces new requirements for insurers and health maintenance organizations (HMOs) regarding the use of artificial intelligence (AI) in claim denials. Specifically, when an insurer or HMO denies a claim based on an AI-generated determination, they must provide the claimant with a written disclosure that includes three key pieces of information: (1) a clear notification that the claim denial was based on an AI determination, (2) an explanation of the basis for the AI's decision, and (3) instructions on how to appeal the denial. The bill defines artificial intelligence as a machine-based system that can infer outputs from input and potentially influence physical or virtual environments. The new disclosure requirements will apply only to claims submitted on or after the bill's effective date of September 1, 2025, giving insurers and HMOs time to prepare for the new transparency rules. The legislation aims to provide more transparency and accountability in insurance claim decisions made using artificial intelligence technologies.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4635