The Alabama Senate has passed legislation that would restrict how insurers use artificial intelligence in prior authorization decisions, requiring that any denial be made by a physician or qualified provider rather than AI alone. The bill mandates that AI tools base determinations on a patient’s individual medical history and clinical documentation—not solely on group-level data—and requires annual certification to the Alabama Department of Insurance confirming systems are non-discriminatory and produce consistent outcomes. Insurers would also need to disclose when AI is used in utilization review. The department would have enforcement authority to investigate violations and impose corrective or disciplinary measures. If enacted (effective Oct. 1), the law would apply broadly to health plans and third-party utilization review entities operating in Alabama, aligning the state with a growing national trend to regulate AI in coverage decisions.
Resource: Alabama bill would restrict insurers’ use of AI in prior authorization decisions