Texas legislation · 89th Legislature Regular Session
Texas SB815: Relating to the use of certain automated systems in, and certain adverse determinations made in connection with, the health benefit claims process.
Status: Signed into law, June 20, 2025
What the bill says
An act relating to the use of certain automated systems in, and certain adverse determinations made in connection with, the health benefit claims process.
From the enrolled text, May 26, 2025:
AN ACT relating to the use of certain automated systems in, and certain adverse determinations made in connection with, the health benefit claims process. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 4201.002, Insurance Code, is amended by amending Subdivision (1) and adding Subdivisions (1-a), (1-b), and (1-c) to read as follows: (1) "Adverse determination" means a determination by a utilization review agent that health care services provided or proposed to be provided to a patient are not medically necessary[ADDED: or ] [ADDED: appropriate]or are experimental or investigational. [ADDED: (1-a)][ADDED: ][ADDED: ][ADDED: "Algorithm" means a computerized procedure ] [ADDED: consisting of a set of steps used to accomplish a determined task.] [ADDED: (1-b)][ADDED: ][ADDED: ][ADDED: "Artificial intelligence system" means any ] [ADDED: machine learning-based system that, for any explicit or implicit ] [ADDED: objective, infers from the inputs the system receives how to ] [ADDED: generate outputs, including content, decisions, predictions, and ] [ADDED: recommendations, that can influence physical or virtual ] [ADDED: environments.] [ADDED: (1-c)][ADDED: ][ADDED: ][ADDED: "Automated decision system" means an algorithm, ] [ADDED: including an algorithm incorporating an artificial intelligence ] [ADDED: system, that uses data-based analytics to make, suggest, or ] [ADDED: recommend certain determinations, decisions, judgments, or ] [ADDED: conclusions.] SECTION 2. Subchapter D, Chapter 4201, Insurance Code, is …
Sponsors
- Charles Schwertner (R, SD-005) · primary sponsor
- Cesar Blanco (D, SD-029)
- Molly Cook (D, SD-015)
- Bryan Hughes (R, SD-001)
- David Spiller (R, HD-068)
- Richard Hayes (R, HD-057)
Latest actions
- : Effective on 9/1/25
- : Signed by the Governor
- : Sent to the Governor
- : Signed in the House
- : Signed in the Senate
- : Reported enrolled
- : House passage reported
- : Statement(s) of vote recorded in Journal
- : Record vote (RV#3465)
- : Passed
Votes
- Insurance Committee Vote (Out of committee): 8 yea, 0 nay, passed
- Business & Commerce Committee Vote (Out of committee): 9 yea, 2 nay, passed
- Record vote RV#3465 (May 24, 2025): 116 yea, 13 nay, passed
- Record vote RV#4041 (May 23, 2025): 128 yea, 10 nay, passed
- Record vote RV#3418 (May 23, 2025): 127 yea, 4 nay, passed
- Rules suspended-Three day rule (March 26, 2025): 30 yea, 0 nay, passed
Subjects: HEALTH MAINTENANCE ORGANIZATIONS, Insurance--Health & Accident, Artificial Intelligence (IQ7C5), AUDITS & AUDITORS, Health Care Providers, PHYSICIANS, Electronic Information Systems, INSURANCE, COMMISSIONER OF
Common questions
- What is SB815?
- SB815 is a bill in the Texas Legislature (89th Legislature Regular Session): Relating to the use of certain automated systems in, and certain adverse determinations made in connection with, the health benefit claims process.
- What does SB815 do?
- In its own words: An act relating to the use of certain automated systems in, and certain adverse determinations made in connection with, the health benefit claims process.
- What is the status of SB815?
- Signed into law as of June 20, 2025. Latest action: Effective on 9/1/25 (June 20, 2025).
- Who sponsored SB815?
- Charles Schwertner (R, SD-005), with 5 co-sponsors.
- Where is the official record for SB815?
- On the Texas Legislature website: https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB00815
Source: official Texas record. Tracked by Delilah, AI for legislation across all 50 states and Congress.