Lawmakers in both Louisiana and Georgia are advancing legislation that would limit how artificial intelligence is used in health insurance coverage decisions—signaling a broader push to ensure clinical judgment remains central in patient care.
In Louisiana, proposed legislation would require that any denial, delay, or modification of care involving AI must include independent human review. A qualified clinician would need to evaluate the case and, in many instances, a physician would be required to personally review the medical record and sign off on the decision. The bill also introduces new transparency requirements, mandating that insurers disclose when AI played a role in a determination and provide documentation upon request.
Additionally, if a denial is influenced by AI, it could be presumed invalid unless the insurer can demonstrate that the final decision was made through independent clinical judgment. Patients would also gain stronger appeal rights, including the ability to challenge AI-influenced decisions without further use of AI during the review process.
Meanwhile, Georgia lawmakers have passed a similar measure focused on preventing AI from making coverage decisions on its own. While insurers could still use AI for administrative support or to assist in reviews, the final determination—especially for denials—must be made by a clinician and cannot be overridden by automated systems.
If enacted, these laws would take effect starting in 2026–2027, giving payers time to adjust workflows and compliance strategies. Together, these efforts reflect growing concern around the role of AI in healthcare decision-making and reinforce the importance of maintaining human oversight in clinical determinations.
Resource: Georgia lawmakers move to limit AI’s role in health insurance denials
Louisiana bill would require human review of AI-driven coverage denials