Maryland HB820: Health Insurance - Utilization Review - Use of Artificial Intelligence

What the bill says

An act concerning Health Insurance - Utilization Review - Use of Artificial Intelligence FOR the purpose of requiring that certain carriers, pharmacy benefits managers, and private review agents ensure that artificial intelligence, algorithm, or other software tools are used in a certain manner when used for conducting utilization review; and generally relating to utilization review and artificial intelligence…

From the enrolled text, June 4, 2025:

AN ACT concerning Health Insurance - Utilization Review - Use of Artificial Intelligence FOR the purpose of requiring that certain carriers, pharmacy benefits managers, and private review agents ensure that artificial intelligence, algorithm, or other software tools are used in a certain manner when used for conducting utilization review; and generally relating to utilization review and artificial intelligence. BY repealing and reenacting, with amendments, Article - Insurance Section 15-10A-06 Annotated Code of Maryland (2017 Replacement Volume and 2024 Supplement) BY adding to Article - Insurance Section 15-10B-05.1 Annotated Code of Maryland (2017 Replacement Volume and 2024 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows: Article - Insurance 15-10A-06. (a) On a quarterly basis, each carrier shall submit to the Commissioner, on the form the Commissioner requires, a report that describes: (1) the number of members entitled to health care benefits under a policy, plan, or certificate issued or delivered in the State by the carrier; (2) the number of clean claims for reimbursement processed by the carrier; (3) the activities of the carrier under this subtitle, (ii) the number and outcomes of cases that were considered emergency cases under § 15-10A-02(b)(2)(i) of this subtitle; Ch. 747 2025 LAWS OF MARYLAND (iii) the time within which the carrier made …

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