Bill > HB579

This bill propto regulates the use of artificial intelligence (AI) by health insurers in Ohio, requiring them to file detailed annual report the state insurance superintendent about their AI usage in utilization review processes, including specifics about algorithm criteria, training data sets, and outcomes, human oversight. The bill prohibits healthers health plan issuers from making medical care decisions solely based on AI algorithms, mandating that that all necessity be made licensed considers the individual patient's circumstances circumstances., Health insurers to plain language explanany AIdo-generated care delay, or services and and that medical necessity determdeterminations must by licensed physicians who review individual clinical records and take The superintendent of can audit AI algorithms at at any time and requires time. The bill defines multiple health care-related terms and applies to health benefit plans issued or renewed after its effective date, aiming to ensure transparency and human oversight in AI-ization driven healthcare decision-making processes. The legislation seeks to prevent potential algorithmic bias and ensure that individualalized decisions prioritize patient-specific clinical needs over automated system recommendations: providing a of detailed overview. Wouldify few - could "lineline C)(1) "based solely results derived results from the or application of artificial intelligence" mean? And other words does the practical interpretation of Assistant: The phrase "essentially based derived derived the use application of artificial intelligence means artificial intelligence" essentially means that an insurers cannot make a final medical about decision, such as denying, delaying, modor medical or treatment, solely based on an only an AI algorithm's's recommendation or output. In practical terms., In other an AI system suggests denying a specific treatment service, a a licensed professional like a physician physician) must also review the's individual case records and make an independent, personalized assessment before confir. The aim to to prevent that that clinical needs aren automaticallyatically by dismissed by an algorithm without human professional medical judgment and context and expertise.

Business and Industry

https://www.legislature.ohio.gov/legislation/136/hb579