AL SB63

Requires health insurers using AI for prior authorization decisions to base determinations on the enrollee's individual medical history, unique clinical circumstances, and medical record information rather than relying solely on group datasets

Mandates that any decision to deny, reduce, or defer a prior authorization request must be made by a licensed physician or qualified health care professional who can evaluate the AI's recommendation against the enrollee's specific circumstances

Requires insurers to provide written disclosure to group plan sponsors or individual enrollees when AI is used in utilization review, and to certify annually to the Alabama Department of Insurance that their AI systems are fair, non-discriminatory, and periodically reviewed for accuracy

Authorizes the Department of Insurance to investigate violations, require corrective action plans, and impose disciplinary measures for repeat violations under existing Code Section 27-3A-6(d)

Effective date: October 1, 2026; passed the Alabama Senate on February 19, 2026 with a vote of 27-0