Bill > HB1787

This bill aims to regulate the use of artificial intelligence (AI), algorithms, and other software tools by health insurance companies when making decisions about whether to approve or deny medical services, a process known as utilization review. The bill specifies that these tools must base their decisions on an individual's medical history and specific clinical circumstances, not just general data, and must be applied consistently and fairly, with transparency for audits. It also mandates that AI and algorithms cannot be used to directly deny, delay, or alter a decision to provide healthcare services. Crucially, before a health carrier can issue an "adverse action" – meaning a denial of a request for prior authorization or other services – a licensed health care provider must conduct an independent review of the claim, considering the patient's history and individual circumstances, and must use their own medical judgment rather than solely relying on automated recommendations. The bill defines "algorithm" as a computerized procedure, "artificial intelligence" as an autonomous system that can generate outputs influencing environments, and "prior authorization" as the requirement for approval before receiving certain services.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=1787&year=2026