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Pa. bill would mandate insurer disclosure of AI in utilization review


Pennsylvania lawmakers have filed legislation that would require insurers to disclose when artificial intelligence is used during the utilization review process.

House Bill 1663, filed Thursday, would mandate health insurers disclose to health care providers, covered individuals and the general public when AI algorithms are used, not used or will be used in the insurer’s utilization review process.

Insurance companies would have to submit the AI algorithms and data sets used in the utilization review process to the state Insurance Department for transparency.

Any violation of the requirement would be deemed an unfair method of competition and an unfair deceptive act or practice and could lead to insurer license revocation or even monetary fines.

Utilization review is a process to assess whether a medical treatment service is reasonable and necessary. One area in which it is often deployed is workers compensation.  

The bill was referred to the House Insurance Committee where it awaits action.