Health Law Highlights

AI in the Health Insurance Industry: An Explainer and Research Roundup

Summary of article from The Journalist’s Response, by Rachel Layne:

As artificial intelligence (AI) becomes increasingly prevalent in health insurance, U.S. states are seeking to regulate its use due to concerns of racial bias and flawed coverage determinations. Major health insurers like Humana, Cigna, and UnitedHealth face lawsuits over alleged improper use of AI in coverage decisions. Various state and federal initiatives aim to increase transparency around AI systems’ creation, data inputs, and decision-making algorithms. The National Conference of State Legislatures reports that at least 40 states have introduced or passed AI-regulating legislation in 2024, with many states modeling their regulations on guidance from the National Association of Insurance Commissioners. However, the varying rules across states could pose challenges for insurers.