Healthcare AI Law Intelligence Feed

This analysis highlights Alabama SB 63 as a landmark law requiring licensed physicians to evaluate AI recommendations before denying or delaying coverage. It also discusses legislative efforts in states like Rhode Island and Tennessee to mandate transparency and human review in AI-assisted insurance claims.

This article reviews new state-level AI regulations, including Texas's TRAIGA, which prohibits AI systems with the intent to discriminate based on protected characteristics. It emphasizes that healthcare organizations remain accountable for vendor-provided AI and must conduct thorough diligence on training data and bias testing.

Pennsylvania's House Bill 1925, passed in September 2026, mandates that healthcare professionals conduct individual record reviews and exercise independent judgment rather than relying on AI for coverage denials. The bill also requires facilities to disclose AI use in clinical decision-making to patients.

This report details Alabama SB 63, which mandates that AI-driven prior authorization denials be reviewed by licensed professionals and requires disclosure of AI use in utilization review. It also highlights other state legislative efforts enacted in 2026 that prohibit insurance coverage decisions from being based solely on AI systems.

This overview highlights that the government is increasingly using AI to identify enforcement targets in healthcare claims data. It warns that organizations are legally responsible for AI output, including ambient scribes and claims-processing algorithms, regardless of whether a third-party vendor manages the tool.

CMS outlines the implementation of electronic prior authorization requirements effective January 1, 2027, which includes the use of AI-assisted models like WISeR. The guidance emphasizes that while technology is used to improve efficiency, Medicare coverage rules remain unchanged and require clinician review.

The Pennsylvania House passed HB 1925, which establishes transparency and accountability requirements for AI in healthcare settings. The bill requires that AI-assisted decisions in clinical care and insurance coverage be subject to human oversight and individualized assessment.

This bill requires hospitals, clinicians, and insurers to disclose AI usage to patients and ensures that human decision-makers remain responsible for clinical care and utilization review outcomes. It mandates that entities provide attestations to state departments regarding their internal AI governance and compliance with anti-discrimination laws.

This analysis discusses the NAIC's development of an AI Risk Evaluation Supplement for insurers and the emergence of state-level AI legislation. It notes that insurers must prepare for new governance, transparency, and safety reporting requirements as states move to regulate AI in insurance operations.

The FDA released a discussion paper to solicit stakeholder feedback on how to regulate generative AI in medical devices. The agency is exploring how to classify risk for autonomous versus provider-supervised AI tools and requested public comments by October 19, 2026.