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.
(A)–(C) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED. (B) "ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B)" MEANS A MACHINE–BASED SYSTEM THAT: (1) CAN, FOR A GIVEN SET OF HUMAN–DEFINED OBJECTIVES, MAKE PREDICTIONS, RECOMMENDATIONS, OR DECISIONS INFLUENCING REAL OR VIRTUAL ENVIRONMENTS; (2) USES MACHINE AND HUMAN–BASED INPUTS TO PERCEIVE REAL AND VIRTUAL ENVIRONMENTS AND ABSTRACTS THOSE PERCEPTIONS INTO MODELS THROUGH ANALYSIS IN AN AUTOMATED MANNER; AND (3) USES MODEL INFERENCE TO FORMULATE OPTIONS FOR INFORMATION OR ACTION. (C) (1) "HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C)" MEANS: (I) A PERSON WHO IS LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED UNDER THE HEALTH OCCUPATIONS ARTICLE OR § 13–516 OF THE EDUCATION ARTICLE TO PROVIDE HEALTH CARE IN THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A PROFESSION OR IN AN APPROVED EDUCATION OR TRAINING PROGRAM; OR (II) A FACILITY WHERE HEALTH CARE IS PROVIDED TO PATIENTS OR RECIPIENTS, INCLUDING: 1. A FACILITY AS DEFINED IN § 10–101 OF THIS ARTICLE; 2. A HOSPITAL AS DEFINED IN § 19–301 OF THIS ARTICLE; 3. A RELATED INSTITUTION AS DEFINED IN § 19–301 OF THIS ARTICLE; 4. A HEALTH MAINTENANCE ORGANIZATION AS DEFINED IN § 19–701 OF THIS ARTICLE; 5. AN OUTPATIENT CLINIC; 6. A MEDICAL LABORATORY; 7. A COMPREHENSIVE CRISIS RESPONSE CENTER; 8. A CRISIS STABILIZATION CENTER; AND 9. A CRISIS TREATMENT CENTER ESTABLISHED UNDER § 7.5–207 OF THIS ARTICLE. (2) "HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C)" INCLUDES AN AGENT, AN EMPLOYEE, AN OFFICER, AND A DIRECTOR OF A FACILITY DESCRIBED IN PARAGRAPH (1)(II) OF THIS SUBSECTION AND AN AGENT AND AN EMPLOYEE OF A PERSON DESCRIBED IN PARAGRAPH (1)(II) OF THIS SUBSECTION.
This section defines the key terms used throughout the new Subtitle 25 governing AI use by health care providers. The definition of artificial intelligence tracks a common three-part functional definition (prediction/recommendation/decision capability, perception-to-model abstraction, and model inference). Health care provider is defined broadly to cover licensed individuals and a wide range of health care facilities, including hospitals, outpatient clinics, medical laboratories, and crisis centers, as well as their agents, employees, officers, and directors.
1 A HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) MAY NOT USE ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) IF THE ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) HAS BEEN DESIGNED ONLY TO REDUCE COSTS FOR A HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) AT THE EXPENSE OF REDUCING THE QUALITY OF PATIENT CARE, DELAYING PATIENT CARE, OR DENYING COVERAGE FOR PATIENT CARE.
This section categorically prohibits health care providers from using AI that has been designed only to reduce costs at the expense of reducing patient care quality, delaying patient care, or denying coverage for patient care. The prohibition is framed around design intent — the AI must have been designed with the sole objective of cost reduction to the detriment of patient care. In practice, applying this standard may be challenging because most AI systems are designed with multiple objectives; the provision would appear to target AI tools whose sole documented design purpose is cost minimization with no patient-care safeguard.
(A)(1)–(6), (B) 2 ON OR BEFORE JULY 1 EACH YEAR, BEGINNING IN 2026, EACH HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) THAT USES ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) TO DETERMINE OR INFLUENCE HEALTH CARE DECISIONS SHALL POST ON THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C)'S WEBSITE DOCUMENTATION DETAILING KEY DATA ABOUT THE DECISIONS MADE USING ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) IN THE IMMEDIATELY PRECEDING YEAR, INCLUDING: (1) THRESHOLDS FOR WHEN A DECISION IS REVIEWED BY AN INDIVIDUAL; (2) RATES OF DECISIONS OVERTURNED AFTER REVIEW BY AN INDIVIDUAL; (3) RATES OF MISDIAGNOSIS; (4) RATES OF MISCALCULATED DOSAGES OF MEDICINE; (5) THE NUMBER OF INSTANCES WHEN A SUGGESTED PLAN OF CARE DISREGARDS A PATIENT'S: (I) PREEXISTING CONDITION; (II) MEDICATIONS THAT HAVE RELATIVE CONTRAINDICATIONS OR ABSOLUTE CONTRAINDICATIONS WITH THE SUGGESTED PLAN; OR (III) CARE PREFERENCES DUE TO PERSONAL BELIEFS; AND (6) ANY OTHER DATA REQUIRED BY THE DEPARTMENT. (B) DATA POSTED IN ACCORDANCE WITH SUBSECTION (A) OF THIS SECTION SHALL BE ARCHIVED AND REMAIN PUBLICLY AVAILABLE ON THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C)'S WEBSITE.
(C)(1)–(2) 3 ON OR BEFORE JULY 1 EACH YEAR, BEGINNING IN 2026, EACH HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) THAT USES ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) TO DETERMINE OR INFLUENCE HEALTH CARE DECISIONS SHALL UNDERGO A THIRD–PARTY AUDIT TO EVALUATE WHETHER THE HEALTH CARE DECISIONS MADE BY AN ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) SYSTEM: (I) ALIGN WITH MEDICAL CARE STANDARDS; (II) MEET ETHICAL STANDARDS; OR (III) DELAY CARE EXCESSIVELY. (2) AT THE REQUEST OF THE DEPARTMENT, A HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) SHALL SUBMIT TO THE DEPARTMENT PROOF THAT AN AUDIT WAS COMPLETED IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION.
This section imposes two annual obligations on health care providers that use AI to determine or influence health care decisions. First, providers must publicly post on their website, by July 1 each year beginning in 2026, documentation covering key performance metrics: human review thresholds, overturn rates, misdiagnosis rates, miscalculated dosage rates, instances where a suggested plan of care disregards a patient's preexisting condition, contraindicated medications, or care preferences, plus any additional data the Department requires. This data must be archived and remain publicly available.
Second, providers must undergo an annual third-party audit evaluating whether AI-driven health care decisions align with medical care standards, meet ethical standards, or delay care excessively. Proof of audit completion must be submitted to the Department on request.
(A)–(B) IF A HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) VIOLATES THIS SUBTITLE, THE DEPARTMENT MAY IMPOSE A PENALTY NOT TO EXCEED $10,000 PER OFFENSE. (B) IN DETERMINING THE AMOUNT OF A PENALTY UNDER SUBSECTION (A) OF THIS SECTION, THE DEPARTMENT SHALL CONSIDER: (1) THE TYPE, SEVERITY, AND DURATION OF THE VIOLATION; (2) WHETHER THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) KNEW OR SHOULD HAVE KNOWN OF THE VIOLATION; (3) THE EXTENT TO WHICH THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) HAS A HISTORY OF VIOLATIONS; AND (4) WHETHER THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) CORRECTED THE VIOLATION AS SOON AS THE HEALTH CARE PROVIDERHealth care provider"Health care provider" means: (I) a person who is licensed, certified, or otherwise authorized under the Health Occupations Article or § 13–516 of the Education Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or (II) a facility where health care is provided to patients or recipients, including: 1. a facility as defined in § 10–101 of this article; 2. a hospital as defined in § 19–301 of this article; 3. a related institution as defined in § 19–301 of this article; 4. a health maintenance organization as defined in § 19–701 of this article; 5. an outpatient clinic; 6. a medical laboratory; 7. a comprehensive crisis response center; 8. a crisis stabilization center; and 9. a crisis treatment center established under § 7.5–207 of this article. (2) "Health care provider" includes an agent, an employee, an officer, and a director of a facility described in paragraph (1)(II) of this subsection and an agent and an employee of a person described in paragraph (1)(II) of this subsection.Health – General § 24–2501(C) KNEW OF THE VIOLATION.
This section establishes the Department of Health's enforcement authority over health care providers that violate Subtitle 25. The Department may impose penalties up to $10,000 per offense. Penalty amounts are calibrated by four factors: the type, severity, and duration of the violation; whether the provider knew or should have known of the violation; violation history; and whether the provider self-corrected upon discovering the violation.
THE DEPARTMENT MAY ADOPT REGULATIONS TO CARRY OUT THIS SUBTITLE.
This section grants the Department of Health broad authority to adopt regulations implementing Subtitle 25. No specific rulemaking timeline or mandatory content is prescribed.
(A)(1)–(3) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED. (2) "ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B)" MEANS A MACHINE–BASED SYSTEM THAT: (I) CAN, FOR A GIVEN SET OF HUMAN–DEFINED OBJECTIVES, MAKE PREDICTIONS, RECOMMENDATIONS, OR DECISIONS INFLUENCING REAL OR VIRTUAL ENVIRONMENTS; (II) USES MACHINE AND HUMAN–BASED INPUTS TO PERCEIVE REAL AND VIRTUAL ENVIRONMENTS AND ABSTRACTS THOSE PERCEPTIONS INTO MODELS THROUGH ANALYSIS IN AN AUTOMATED MANNER; AND (III) USES MODEL INFERENCE TO FORMULATE OPTIONS FOR INFORMATION OR ACTION. (3) (I) "CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3)" MEANS: 1. AN INSURER AUTHORIZED TO SELL HEALTH INSURANCE; 2. A NONPROFIT HEALTH SERVICE PLAN; 3. A HEALTH MAINTENANCE ORGANIZATION; 4. A DENTAL PLAN ORGANIZATION; AND 5. ANY OTHER ENTITY PROVIDING A PLAN OF HEALTH INSURANCE, HEALTH BENEFITS, OR HEALTH SERVICES AUTHORIZED UNDER THE INSURANCE ARTICLE OR THE FEDERAL AFFORDABLE CARE ACT. (II) "CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3)" INCLUDES THE AGENTS, EMPLOYEES, OFFICERS, AND DIRECTORS OF AN ENTITY DESCRIBED IN SUBPARAGRAPH (I) OF THIS PARAGRAPH.
(B) 4 A CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) MAY NOT USE ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) IF THE ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) HAS BEEN DESIGNED ONLY TO REDUCE COSTS FOR A CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) AT THE EXPENSE OF REDUCING THE QUALITY OF PATIENT CARE, DELAYING PATIENT CARE, OR DENYING COVERAGE FOR PATIENT CARE.
(C)(1)–(2) 5 ON OR BEFORE JULY 1 EACH YEAR, BEGINNING IN 2026, EACH CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) THAT USES ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) TO DETERMINE OR INFLUENCE HEALTH CARE DECISIONS SHALL POST ON THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3)'S WEBSITE DOCUMENTATION DETAILING KEY DATA ABOUT THE DECISIONS MADE USING ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) IN THE IMMEDIATELY PRECEDING YEAR, INCLUDING: (I) THRESHOLDS FOR WHEN A DECISION IS REVIEWED BY AN INDIVIDUAL; (II) RATES OF DECISIONS OVERTURNED AFTER REVIEW BY AN INDIVIDUAL; (III) DENIAL RATES; (IV) CRITERIA USED FOR APPROVALS OR DENIALS; AND (V) ANY OTHER DATA REQUIRED BY THE COMMISSIONER. (2) DATA POSTED IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION SHALL BE ARCHIVED AND REMAIN PUBLICLY AVAILABLE ON THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3)'S WEBSITE.
(D)(1)–(2) 6 ON OR BEFORE JULY 1 EACH YEAR, BEGINNING IN 2026, EACH CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) THAT USES ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) TO DETERMINE OR INFLUENCE HEALTH CARE DECISIONS SHALL UNDERGO A THIRD–PARTY AUDIT TO EVALUATE WHETHER THE HEALTH CARE DECISIONS MADE BY AN ARTIFICIAL INTELLIGENCEArtificial intelligence"Artificial intelligence" means a machine–based system that: (1) can, for a given set of human–defined objectives, make predictions, recommendations, or decisions influencing real or virtual environments; (2) uses machine and human–based inputs to perceive real and virtual environments and abstracts those perceptions into models through analysis in an automated manner; and (3) uses model inference to formulate options for information or action.Health – General § 24–2501(B) SYSTEM: (I) ALIGN WITH MEDICAL CARE STANDARDS; (II) MEET ETHICAL STANDARDS; OR (III) DELAY CARE EXCESSIVELY. (2) AT THE REQUEST OF THE COMMISSIONER, A CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) SHALL SUBMIT PROOF TO THE COMMISSIONER THAT AN AUDIT WAS COMPLETED IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION.
(E)(1)–(2) IF A CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) VIOLATES THIS SUBTITLE, THE COMMISSIONER MAY IMPOSE A PENALTY NOT EXCEEDING $10,000 PER OFFENSE. (2) IN DETERMINING THE AMOUNT OF A PENALTY UNDER PARAGRAPH (1) OF THIS SUBSECTION, THE COMMISSIONER SHALL CONSIDER: (I) THE TYPE, SEVERITY, AND DURATION OF THE VIOLATION; (II) WHETHER THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) KNEW OR SHOULD HAVE KNOWN OF THE VIOLATION; (III) THE EXTENT TO WHICH THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) HAS A HISTORY OF VIOLATIONS; AND (IV) WHETHER THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) CORRECTED THE VIOLATION AS SOON AS THE CARRIERCarrier"Carrier" means: (I) 1. an insurer authorized to sell health insurance; 2. a nonprofit health service plan; 3. a health maintenance organization; 4. a dental plan organization; and 5. any other entity providing a plan of health insurance, health benefits, or health services authorized under the Insurance Article or the Federal Affordable Care Act. (II) "Carrier" includes the agents, employees, officers, and directors of an entity described in subparagraph (I) of this paragraph.Insurance § 15–147(A)(3) KNEW OF THE VIOLATION.
(F) THE COMMISSIONER MAY ADOPT REGULATIONS TO CARRY OUT THIS SECTION.
This section mirrors the Health – General provisions but applies to health insurance carriers regulated under the Insurance Article. It defines carrier broadly to include health insurers, nonprofit health service plans, HMOs, dental plan organizations, and any other entity providing health insurance or benefits under state or federal law, plus their agents, employees, officers, and directors.
Carriers face the same categorical prohibition on using AI designed only to reduce costs at the expense of patient care. The annual public website disclosure requirement parallels the provider obligation but with carrier-specific metrics: human review thresholds, overturn rates, denial rates, criteria used for approvals or denials, and any additional data the Commissioner requires. Carriers must also undergo the same annual third-party audit and submit proof to the Insurance Commissioner on request. Penalties mirror the provider side at up to $10,000 per offense with the same four calibration factors. The Commissioner receives independent rulemaking authority.