KS SB467

Health insurers and utilization review organizations in Kansas are prohibited from using AI, algorithms, or software tools to deny, delay, or modify healthcare services based on medical necessity determinations

All medical necessity determinations must be made by a licensed physician or healthcare professional competent to evaluate the specific clinical issues involved, after reviewing the provider's recommendation and patient's medical history

AI tools used in utilization review must base determinations on individual patient clinical history and circumstances, not solely on group datasets, and must not supplant healthcare provider decision-making or cause harm to enrollees

Health insurers must establish written policies describing their utilization review processes, file these policies with the Kansas Department of Insurance, and disclose them to insureds, providers, and the public upon request

The act takes effect upon publication in the statute book