Maryland · Senate Bill · 2025 Regular Session
SB987
Maryland Senate Bill 987 — Artificial Intelligence – Health Software and Health Insurance Decision Making

Status ● Failed Effective N/A Passage Likelihood L

WHAT THIS BILL REGULATES · 2 REQUIREMENT TYPES

How Is This Bill Enforced

Enforcement Authority
The Maryland Health Care Commission enforces the AI health software registry provisions and may impose administrative fines for distributing or operating unregistered AI health software. The Maryland Insurance Administration regulates carriers subject to the AI prohibition in § 15–147. No private right of action is created.
Private Right of Action
No private right of action. Enforcement is exclusive to the designated authority.
Penalties
The Commission may fine a person up to $10,000 per day for distributing or operating unregistered AI health software. Fine amount is based on the extent of actual or potential harm, the cost of investigating the violation, and whether the person committed previous violations. No private damages remedy is created.

What This Bill Requires

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.

Statutory Text
Analysis & Obligations
Md. Code, Health–Gen. § 19–150
Artificial Intelligence Health Software Registry
DeployerDeveloperGovernment

(A) 1 THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 SHALL MAINTAIN A REGISTRY OF ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) THAT MAY BE DISTRIBUTED OR OPERATED IN THE STATE.

(B) 2 A PERSON MAY NOT DISTRIBUTE OR OPERATE ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) IN THE STATE UNLESS THE SOFTWARE IS REGISTERED WITH THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101.

(C)(1)–(3) THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 SHALL ADOPT REGULATIONS THAT: (1) DEFINE ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1); (2) DETERMINE THE INFORMATION ABOUT ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) TO BE COLLECTED FOR THE REGISTRY; AND (3) SET A REGISTRATION DEADLINE FOR WHEN THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 WILL BEGIN TO ISSUE FINES TO A PERSON THAT DISTRIBUTES OR OPERATES UNREGISTERED ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) IN THE STATE.

(D)(1)–(2) IF A PERSON DISTRIBUTES OR OPERATES UNREGISTERED ARTIFICIAL INTELLIGENCE HEALTH SOFTWAREArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) IN THE STATE, THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 MAY FINE THE PERSON UP TO $10,000 FOR EACH DAY THE VIOLATION OCCURRED. (2) THE AMOUNT OF THE FINE IMPOSED BY THE COMMISSIONCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 UNDER PARAGRAPH (1) OF THIS SUBSECTION SHALL BE BASED ON: (I) THE EXTENT OF ACTUAL OR POTENTIAL HARM RELATED TO THE VIOLATION; (II) THE COST OF INVESTIGATING THE VIOLATION; AND (III) WHETHER THE PERSON COMMITTED PREVIOUS VIOLATIONS OF THIS SECTION.

Section 19–150 creates a new regulatory framework requiring the Maryland Health Care Commission to establish and maintain a registry of AI health software that may be distributed or operated in the state. No person may distribute or operate AI health software in Maryland without registering it with the Commission. Notably, the statute delegates the definition of artificial intelligence health software to Commission rulemaking, meaning the precise scope of coverage will not be known until regulations are adopted.

The Commission is directed to adopt regulations defining the covered software, determining what information registrants must submit, and setting a registration deadline after which fines will be imposed. Violations carry administrative fines of up to $10,000 per day, calibrated to actual or potential harm, investigation costs, and the violator's history of prior violations.

Compliance actions 2 items
1
The Maryland Health Care CommissionCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 must establish and maintain a registry of artificial intelligence health softwareArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) that may be distributed or operated in the state.
R-02.3
2
Persons must register artificial intelligence health softwareArtificial intelligence health softwareDefinition deferred to regulations adopted by the Maryland Health Care Commission under § 19–150(C)(1).Md. Code, Health–Gen. § 19–150(C)(1) with the Maryland Health Care CommissionCommission"Commission" means the Maryland Health Care Commission.Md. Code, Health–Gen. § 19–101 before distributing or operating the software in Maryland.
R-02.3
Md. Code, Ins. § 15–147
Prohibition on Carrier Use of AI in Health Care Decisions
Deployer

(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.Md. Code, State Fin. & Proc. § 3.5–801(c)" HAS THE MEANING STATED IN § 3.5–801 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. (3) "CARRIERCarrier"Carrier" means: (I) an insurer; (II) a nonprofit health service plan; (III) a health maintenance organization; (IV) a dental plan organization; or (V) any other person that provides health benefit plans subject to regulation by the State.Md. Code, Ins. § 15–147(A)(3)" MEANS: (I) AN INSURER; (II) A NONPROFIT HEALTH SERVICE PLAN; (III) A HEALTH MAINTENANCE ORGANIZATION; (IV) A DENTAL PLAN ORGANIZATION; OR (V) ANY OTHER PERSON THAT PROVIDES HEALTH BENEFIT PLANS SUBJECT TO REGULATION BY THE STATE.

(B) 3 A CARRIERCarrier"Carrier" means: (I) an insurer; (II) a nonprofit health service plan; (III) a health maintenance organization; (IV) a dental plan organization; or (V) any other person that provides health benefit plans subject to regulation by the State.Md. Code, Ins. § 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.Md. Code, State Fin. & Proc. § 3.5–801(c) TO DECIDE OR DIRECTLY INFLUENCE A HEALTH CARE DECISION OR A DECISION DIRECTLY RELATED TO HEALTH CARE.

(C) THIS SECTION MAY NOT BE CONSTRUED TO PROHIBIT A CARRIERCarrier"Carrier" means: (I) an insurer; (II) a nonprofit health service plan; (III) a health maintenance organization; (IV) a dental plan organization; or (V) any other person that provides health benefit plans subject to regulation by the State.Md. Code, Ins. § 15–147(A)(3) FROM 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.Md. Code, State Fin. & Proc. § 3.5–801(c) TO PERFORM TASKS OR MAKE DECISIONS THAT ARE NOT RELATED TO HEALTH CARE.

Section 15–147 imposes a categorical prohibition on health insurance carriers using artificial intelligence to decide or directly influence any health care decision or decision directly related to health care. The prohibition applies broadly to insurers, nonprofit health service plans, HMOs, dental plan organizations, and any other person providing state-regulated health benefit plans.

A savings clause preserves carriers' ability to use AI for tasks and decisions unrelated to health care — such as fraud detection, administrative processing, or customer service — making clear the prohibition targets only the clinical and coverage decision-making context. This is one of the broadest state-level restrictions on insurer use of AI, going further than most state bills that merely require human oversight of AI-assisted coverage decisions.

Compliance actions 1 item
3
Health insurance carriersCarrier"Carrier" means: (I) an insurer; (II) a nonprofit health service plan; (III) a health maintenance organization; (IV) a dental plan organization; or (V) any other person that provides health benefit plans subject to regulation by the State.Md. Code, Ins. § 15–147(A)(3) must 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.Md. Code, State Fin. & Proc. § 3.5–801(c) to decide or directly influence any health care decision or any decision directly related to health care. AI may still be used for tasks and decisions unrelated to health care.
HC-01.1

Passage Likelihood

Failed
Status Failed
Final action Hearing 2/27 at 1:00 p.m.

Legislative History

2025-02-03 First Reading Finance
2025-02-06 Hearing 2/27 at 1:00 p.m.

Entry Last Reviewed

2026-05-20
AI generated