A bill for an act relating to health carriers standards of conduct; utilization review organizations, artificial intelligence, audits, and prior authorizations; certificate of need processes; and including applicability provisions.

Summary

The act lets utilization review groups use AI for an initial look at prior‑authorization requests but bans AI as the sole reason to deny, delay, or downgrade a medically necessary service. It also bars health carriers from penalizing providers for out‑of‑network referrals, requires negotiation for contract changes, and adds new timelines for audits. Finally, it widens prior‑authorization exemptions for cancer screenings and emergencies, and rewrites the certificate‑of‑need application, fee, and review procedures.

AI-generated summary — may be incomplete or inaccurate. Verify against the official bill text.

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