relative to health carrier recordkeeping requirements in utilization review, including specifications regarding the use of artificial intelligence.

The bill changed from creating a new standalone section prohibiting AI use in provider coding to amending the existing utilization review section (RSA 420-J:6). The title changed from 'prohibiting health carriers from using artificial intelligence to change the clinical judgment of a provider' to 'relative to health carrier recordkeeping requirements in utilization review, including specifications regarding the use of artificial intelligence.'

New contracting liability provision: when a health carrier contracts with another entity to perform utilization review functions (including AI systems developed by that entity), the commissioner holds the carrier responsible for monitoring the contracted entity's activities and ensuring compliance with the section's requirements.

The introduced version's enforcement mechanism was removed: violations were no longer classified as an unfair insurance practice under RSA 417, and the commissioner's authority to impose administrative fines or order restitution for delays or denials of care resulting from AI misuse was eliminated.

New requirement that all adverse determinations (including payment reductions and down coding) must be made by a qualified health care provider, with written notice provided to both the covered person and their provider detailing the reason for the decision.

New recordkeeping requirements: carriers must maintain written records about which functions AI is used for, protocols ensuring qualified human review of determinations affecting provider coding decisions, information submitted and reviewed, applicable clinical guidelines, whether AI assisted the reviewer, and the clinical rationale for each adverse determination.