Summary
Updates Utah’s health-insurance preauthorization law by adding definitions for artificial intelligence and generative artificial intelligence, tightening decision timelines, expanding reporting, requiring clearer adverse-determination notices, and reinforcing clinician-led review of medical-necessity denials.
Healthcare Implications
Directly affects how insurers use AI in prior authorization and utilization management by requiring disclosure and reporting around AI-linked workflows while preserving human clinical judgment in adverse determinations. The law is highly relevant to payer oversight, provider burden, and patient access to timely medically necessary care.
Operational Implications
- Adverse PA determinations require independent medical judgment; insurer may not rely solely on AI recommendations.
- Must disclose when AI is used in preauthorization processes.