Summary
Regulates the use of artificial intelligence by health insurers by amending R.C. 3902.50 and enacting 3902.80; bill status: introduced and in Senate committee during the 136th GA. Targets AI‑driven determinations and establishes guardrails in insurance operations.
Healthcare Implications
Would limit reliance on AI in coverage determinations and utilization management, aiming to preserve due process and human review. If enacted, Ohio payers must document AI use, ensure explainability, and provide consumer remedies–affecting providers’ prior auth workflows and patient appeals.
Operational Implications
- Health plan issuers must report to the Department of Insurance whether they use AI-based algorithms in UR, including: algorithm criteria, data sets used to train the algorithm, the algorithm itself, outcomes, and time a human reviewer spends examining each adverse determination before sign-off.
- Superintendent of Insurance publishes aggregated reports on insurer website and Department website. AI provisions embedded in larger budget bill.