OK HB3675

Requires any adverse determination (denial of coverage as not medically necessary or appropriate) made by an algorithm, artificial intelligence system, or automated decision system to be reviewed by a qualified human professional before being finalized

Grants the Insurance Commissioner authority to audit and inspect utilization review agents' use of automated decision systems at any time

Permits continued use of AI and automated systems for administrative support and fraud detection functions

Mandates adverse determination notices include principal reasons, clinical basis, description of screening criteria and review procedures, and information about the complaint and appeal process including independent review organization options

Effective date: November 1, 2026