MD HB795

Health insurance carriers must provide human review of grievances when adverse decisions were made using artificial intelligence, algorithms, or other software tools

Carriers must submit quarterly reports to the Insurance Commissioner on AI-related grievances, broken down by claim type, member demographics (race, gender, profession), and policy type

If more than a Commissioner-specified percentage of adverse decisions from the same AI tool result in grievances within 6 months, carriers must conduct a model review process and report findings

AI tools used for utilization review must base determinations on individual enrollee medical history and clinical circumstances, not solely on group datasets, and may not deny, delay, or modify health care services

The act takes effect October 1, 2026