Prescribes requirements and safeguards for the use of an artificial intelligence, algorithm, or other software tool for the purpose of utilization review for health and accident insurance.
Impact
By establishing clear guidelines for the use of AI, this legislation could lead to significant changes in how health insurers evaluate claims and determine coverage for their policyholders. Insurers using these technologies must comply with comprehensive criteria that include safeguarding against discrimination and ensuring fairness in the application of AI tools. This would likely enhance the credibility of AI in the healthcare sector and align its use with existing regulations to prevent potential biases and preserve patient rights.
Summary
Bill S07896 introduced in New York aims to amend the public health law and insurance law to outline requirements and safeguards for the utilization of artificial intelligence (AI), algorithms, or other software tools in the context of health and accident insurance. The bill emphasizes incorporating specific medical criteria when AI is employed for utilization reviews, which assess the necessity of healthcare services. This initiative seeks to ensure that AI tools do not entirely replace provider decision-making nor base their determinations solely on group datasets, thereby maintaining a degree of human oversight in critical health decisions.
Contention
However, there may be contention regarding the balance between technological efficiency and the preservation of personalized healthcare. As AI becomes more ingrained in medical decision-making, concerns could arise about over-reliance on technology versus the nuanced understanding of medical professionals. Some stakeholders might argue that these regulations are either too restrictive or not sufficient enough to genuinely protect patient interests, depending on their perspectives on technology in healthcare.
Same As
Prescribes requirements and safeguards for the use of an artificial intelligence, algorithm, or other software tool for the purpose of utilization review for health and accident insurance.
Prescribes requirements and safeguards for the use of an artificial intelligence, algorithm, or other software tool for the purpose of utilization review for health and accident insurance.
Establishes requirements for the use of artificial intelligence, algorithm, or other software tools in utilization review and management; defines artificial intelligence.
Relates to the use of artificial intelligence by insurers and clinical peer reviewers for utilization review; establishes additional notice requirements for adverse determinations.
Relating to the use of artificial intelligence-based algorithms by health benefit plan issuers, utilization review agents, health care providers, and physicians.
Providing for artificial intelligence in facilities, for artificial intelligence use by insurers and for artificial intelligence use by MA or CHIP managed care plans; imposing duties on the Department of Health, the Insurance Department and the Department of Human Services; and imposing penalties.
Providing for artificial intelligence in facilities, for artificial intelligence use by insurers and for artificial intelligence use by MA or CHIP managed care plans; imposing duties on the Department of Health, the Insurance Department and the Department of Human Services; and imposing penalties.
Prescribes requirements and safeguards for the use of an artificial intelligence, algorithm, or other software tool for the purpose of utilization review for health and accident insurance.