AN ACT RELATING TO INSURANCE -- THE TRANSPARENCY AND ACCOUNTABILITY IN ARTIFICIAL INTELLIGENCE USE BY HEALTH INSURERS TO MANAGE COVERAGE AND CLAIMS ACT

HB 7190 requires health insurers in Rhode Island to disclose how they use artificial intelligence (AI) to manage healthcare claims and coverage decisions. Insurers must report AI models, training data, performance metrics, and documentation of AI-influenced decisions to state regulators, and maintain records for five years. Crucially, the bill mandates that any AI-driven denial of medically necessary care must be reviewed and approved by a licensed healthcare provider with the same specialty as the ordering provider before finalization. This directly affects insurers, enrollees (patients), and healthcare providers by adding human oversight to AI decisions on coverage. The law aims to ensure transparency and accountability in AI use for non-administrative coverage decisions, such as denials of medically necessary treatments.