WHAT THIS BILL REGULATES · 3 REQUIREMENT TYPES
How Is This Bill Enforced
Verbatim statutory text on the left; plain-language analysis and a per-section checklist on the right. Numbered markers cross-link to the matching checklist row.
(b) to confidentiality of all records and communications to the extent provided by law;
(b ½) 1 (b ½) to be informed, if the information they are receiving either verbally or in writing has been generated by artificial intelligence, and to be provided with instructions about how to contact a human healthcare provider in the event that such information was not previously reviewed and approved by their provider;
This section creates a new patient right in the Massachusetts patients' bill of rights. Patients must be told when health information they receive — whether verbal or written — has been generated by artificial intelligence. When such AI-generated information was not previously reviewed and approved by the patient's provider, the patient must also receive instructions for contacting a human healthcare provider. The obligation runs to whoever delivers the information under the existing § 70E framework, which applies broadly to healthcare facilities.
(9 ½) 2 (9 ½) a disclosure if artificial intelligence algorithms or automated decision tools are being utilized or will be utilized in the claims review process, such a disclosure must include a summary of what tools are being used and how they are being used throughout the claims review process;
This section adds a new disclosure requirement to the managed care consumer information provisions. Health insurance carriers must disclose to insureds whether AI algorithms or automated decision tools are being used or will be used in the claims review process. The disclosure must include a summary of the specific tools being used and an explanation of how they are deployed throughout claims review. This is a consumer-facing transparency obligation, distinct from the regulator-facing filing obligation in Section 3.
(g) 3 A carrier shall submit to the division of insurance, no later than December 31 each year, a form to be prescribed by the division, which shall detail the artificial intelligence algorithms and data training sets that are currently being used or will be used in the utilization review process by the carrier. A carrier shall also submit an attestation, in a manner and form prescribed by the division, that such algorithms and training data sets have minimized the risk of bias based on the covered person's race, color, religious creed, ancestry, age, sex, gender, national origin, handicap or disability, and adhere to evidence-based clinical guidelines.
This section imposes two distinct regulatory-filing obligations on health insurance carriers. First, carriers must annually submit to the Division of Insurance a prescribed form detailing the AI algorithms and data training sets used or planned for use in utilization review. Second, carriers must submit an attestation — also in a form prescribed by the Division — certifying that their algorithms and training data have minimized bias risk based on protected characteristics (race, color, religious creed, ancestry, age, sex, gender, national origin, handicap, or disability) and adhere to evidence-based clinical guidelines. The annual deadline is December 31.