GA SB444

Private review agents and utilization review entities are prohibited from using artificial intelligence systems, AI, or other software tools as the sole basis for adverse determinations on healthcare insurance coverage

AI and software tools cannot supersede the judgment of a clinical peer when making coverage decisions

Private review agents may still use AI systems for automating tasks, reducing administrative burdens, and participating in decision-making processes when part of an approved utilization review plan

"Artificial intelligence" is defined as a machine-based system that makes predictions, recommendations, or decisions influencing real or virtual environments for human-defined objectives

Effective date: January 1, 2027